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在间质性肺疾病中探寻可治疗的特征。

Walking the path of treatable traits in interstitial lung diseases.

机构信息

Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.

IRCCS Humanitas Research Hospital, Respiratory Unit, Via Manzoni 56, 20089, Rozzano, Milan, Italy.

出版信息

Respir Res. 2023 Oct 24;24(1):251. doi: 10.1186/s12931-023-02554-8.

Abstract

Interstitial lung diseases (ILDs) are complex and heterogeneous diseases. The use of traditional diagnostic classification in ILD can lead to suboptimal management, which is worsened by not considering the molecular pathways, biological complexity, and disease phenotypes. The identification of specific "treatable traits" in ILDs, which are clinically relevant and modifiable disease characteristics, may improve patient's outcomes. Treatable traits in ILDs may be classified into four different domains (pulmonary, aetiological, comorbidities, and lifestyle), which will facilitate identification of related assessment tools, treatment options, and expected benefits. A multidisciplinary care team model is a potential way to implement a "treatable traits" strategy into clinical practice with the aim of improving patients' outcomes. Multidisciplinary models of care, international registries, and the use of artificial intelligence may facilitate the implementation of the "treatable traits" approach into clinical practice. Prospective studies are needed to test potential therapies for a variety of treatable traits to further advance care of patients with ILD.

摘要

间质性肺疾病(ILDs)是复杂且异质性的疾病。ILD 中传统的诊断分类方法可能导致管理效果不佳,如果不考虑分子途径、生物学复杂性和疾病表型,则情况会更糟。ILD 中特定的“可治疗特征”(具有临床相关性且可改变的疾病特征)的识别可能会改善患者的预后。ILD 中的可治疗特征可分为四个不同的领域(肺部、病因、合并症和生活方式),这将有助于确定相关的评估工具、治疗选择和预期获益。多学科护理团队模式是将“可治疗特征”策略付诸临床实践以改善患者预后的一种潜在方法。多学科护理模式、国际登记处以及人工智能的使用可能会促进“可治疗特征”方法在临床实践中的应用。需要开展前瞻性研究来测试针对各种可治疗特征的潜在治疗方法,以进一步改善ILD 患者的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41a7/10594881/f8a1612b9200/12931_2023_2554_Fig1_HTML.jpg

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