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可治疗特征:间质性肺病的综合精准医疗方法。

Treatable traits: a comprehensive precision medicine approach in interstitial lung disease.

机构信息

Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, Australia

Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Australia.

出版信息

Eur Respir J. 2023 Jul 27;62(1). doi: 10.1183/13993003.00404-2023. Print 2023 Jul.

Abstract

Interstitial lung disease (ILD) is a diverse group of inflammatory and fibrotic lung conditions causing significant morbidity and mortality. A multitude of factors beyond the lungs influence symptoms, health-related quality of life, disease progression and survival in patients with ILD. Despite an increasing emphasis on multidisciplinary management in ILD, the absence of a framework for assessment and delivery of comprehensive patient care poses challenges in clinical practice. The treatable traits approach is a precision medicine care model that operates on the premise of individualised multidimensional assessment for distinct traits that can be targeted by specific interventions. The potential utility of this approach has been described in airway diseases, but has not been adequately considered in ILD. Given the similar disease heterogeneity and complexity between ILD and airway diseases, we explore the concept and potential application of the treatable traits approach in ILD. A framework of aetiological, pulmonary, extrapulmonary and behavioural and lifestyle treatable traits relevant to clinical care and outcomes for patients with ILD is proposed. We further describe key research directions to evaluate the application of the treatable traits approach towards advancing patient care and health outcomes in ILD.

摘要

间质性肺疾病(ILD)是一组异质性的炎症和纤维化肺部疾病,可导致较高的发病率和死亡率。除肺部以外,众多因素会影响ILD 患者的症状、健康相关生活质量、疾病进展和生存。尽管ILD 的多学科管理越来越受到重视,但缺乏评估和提供全面患者护理的框架,给临床实践带来了挑战。可治疗特征方法是一种精准医疗护理模式,其前提是对可通过特定干预措施靶向的不同特征进行个体化多维评估。该方法在气道疾病中的潜在应用已被描述,但在ILD 中尚未得到充分考虑。鉴于ILD 和气道疾病之间存在相似的疾病异质性和复杂性,我们探讨了可治疗特征方法在ILD 中的概念和潜在应用。提出了一个与ILD 患者临床护理和结局相关的病因学、肺部、肺外和行为及生活方式可治疗特征的框架。我们进一步描述了关键的研究方向,以评估可治疗特征方法在推进ILD 患者护理和健康结局方面的应用。

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