scholarly journals Treatable traits: toward precision medicine of chronic airway diseases

2016 ◽  
Vol 47 (2) ◽  
pp. 410-419 ◽  
Author(s):  
Alvar Agusti ◽  
Elisabeth Bel ◽  
Mike Thomas ◽  
Claus Vogelmeier ◽  
Guy Brusselle ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Social Impact ◽  
Chronic Obstructive ◽  
Biological Mechanisms ◽  
Psychosocial Characteristics ◽  
Obstructive Pulmonary Disease ◽  
Airway Diseases ◽  
Clinical Presentations ◽  
Genetic Biomarker ◽  
Chronic Airway

Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent chronic airway diseases that have a high personal and social impact. They likely represent a continuum of different diseases that may share biological mechanisms (i.e. endotypes), and present similar clinical, functional, imaging and/or biological features that can be observed (i.e. phenotypes) which require individualised treatment. Precision medicine is defined as “treatments targeted to the needs of individual patients on the basis of genetic, biomarker, phenotypic, or psychosocial characteristics that distinguish a given patient from other patients with similar clinical presentations”. In this Perspective, we propose a precision medicine strategy for chronic airway diseases in general, and asthma and COPD in particular.

scholarly journals Precision medicine in airway diseases: moving to clinical practice

2017 ◽  
Vol 50 (4) ◽  
pp. 1701655 ◽  
Author(s):  
Alvar Agustí ◽  
Mona Bafadhel ◽  
Richard Beasley ◽  
Elisabeth H. Bel ◽  
Rosa Faner ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Precision Medicine ◽  
Chronic Obstructive ◽  
European Respiratory Society ◽  
Obstructive Pulmonary Disease ◽  
Airway Diseases ◽  
Assessment And Treatment ◽  
Key Questions ◽  
Society Research

On February 21, 2017, a European Respiratory Society research seminar held in Barcelona discussed how to best apply precision medicine to chronic airway diseases such as asthma and chronic obstructive pulmonary disease. It is now clear that both are complex and heterogeneous diseases, that often overlap and that both require individualised assessment and treatment. This paper summarises the presentations and discussions that took place during the seminar. Specifically, we discussed the need for a new taxonomy of human diseases, the role of different players in this scenario (exposome, genes, endotypes, phenotypes, biomarkers and treatable traits) and a number of unanswered key questions in the field. We also addressed how to deploy airway precision medicine in clinical practice today, both in primary and specialised care. Finally, we debated the type of research needed to move the field forward.

scholarly journals Decreased eosinophil counts and elevated lactate dehydrogenase predict severe COVID-19 in patients with underlying chronic airway diseases

2021 ◽  
pp. postgradmedj-2021-139704
Author(s):  
Dian Chen ◽  
Shuchen Zhang ◽  
Yuchen Feng ◽  
Wenliang Wu ◽  
Chenli Chang ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Chronic Bronchitis ◽  
Disease Severity ◽  
Eosinophil Count ◽  
Treatment Effectiveness ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Airway Diseases ◽  
New City ◽  
Chronic Airway

BackgroundSeveral predictors of COVID-19 severity have been reported. However, chronic airway inflammation characterised by accumulated lymphocytes or eosinophils may affect the pathogenesis of COVID-19.MethodsIn this retrospective cohort study, we reviewed the medical records of all patients with laboratory-confirmed COVID-19 with chronic bronchitis, chronic obstructive pulmonary disease (COPD) and asthma admitted to the Sino-French New City Branch of Tongji Hospital, a large regional hospital in Wuhan, China, from 26 January to 3 April. The Tongji Hospital Ethics Committee approved this study.ResultsThere were 59 patients with chronic bronchitis, COPD and asthma. When compared with non-severe patients, severe patients were more likely to have decreased lymphocyte counts (0.6×10⁹/L vs 1.1×10⁹/L, p<0.001), eosinopaenia (<0.02×10⁹/L; 73% vs 24%, p<0.001), increased lactate dehydrogenase (LDH) (471.0 U/L vs 230.0 U/L, p<0.001) and elevated interleukin 6 level (47.4 pg/mL vs 5.7 pg/mL, p=0.002) on admission. Eosinopaenia and elevated LDH were significantly associated with disease severity in both univariate and multivariate regression models including the above variables. Moreover, eosinophil count and LDH level tended to return to normal range over time in both groups after treatment and severe patients recovered slower than non-severe patients, especially in eosinophil count.ConclusionsEosinopaenia and elevated LDH are potential predictors of disease severity in patients with COVID-19 with underlying chronic airway diseases. In addition, they could indicate disease progression and treatment effectiveness.

scholarly journals Use of Hyaluronic Acid (HA) in Chronic Airway Diseases

Cells ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 2210
Author(s):  
Luis Máiz Carro ◽  
Miguel A. Martínez-García
Keyword(s):  
Hyaluronic Acid ◽  
Chronic Obstructive ◽  
Hydration Properties ◽  
Water Binding ◽  
Obstructive Pulmonary Disease ◽  
Airway Diseases ◽  
Copd Patients ◽  
Surface Liquid ◽  
Chronic Airway

Hyaluronic acid (HA) is a key component of the extracellular matrix of the lungs. A unique attribute of HA is its water-retaining properties, so HA has a major role in the regulation of fluid balance in the lung interstitium. Hyaluronic acid has been widely used in the treatment of eyes, ears, joints and skin disorders, but in the last years, it has been also proposed in the treatment of certain lung diseases, including airway diseases, due to its anti-inflammatory and water-binding capacities. Hyaluronic acid aerosol decreases the severity of elastase-induced emphysema in murine models, prevents bronchoconstriction in asthmatics and improves some functional parameters in chronic obstructive pulmonary disease (COPD) patients. Due to the protection of HA against bronchoconstriction and its hydration properties, inhaled HA would increase the volume of airway surface liquid, resulting in mucus hydration, increased mucous transport and less mucous plugging of the airways. In addition, it has been seen in human studies that the treatment with nebulised HA improves the tolerability of nebulised hypertonic saline (even at 6% or 7% of concentration), which has been demonstrated to be an effective treatment in bronchial secretion management in patients with cystic fibrosis and bronchiectasis. Our objective is to review the role of HA treatment in the management of chronic airway diseases.

scholarly journals Host–microbe interactions in distal airways: relevance to chronic airway diseases

2015 ◽  
Vol 24 (135) ◽  
pp. 78-91 ◽  
Author(s):  
Clémence Martin ◽  
Pierre-Régis Burgel ◽  
Patricia Lepage ◽  
Claire Andréjak ◽  
Jacques de Blic ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Disease Onset ◽  
Chronic Obstructive ◽  
Special Focus ◽  
Post Transplantation ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Airway Diseases ◽  
Host Microbe Interactions ◽  
Chronic Airway

This article is the summary of a workshop, which took place in November 2013, on the roles of microorganisms in chronic respiratory diseases. Until recently, it was assumed that lower airways were sterile in healthy individuals. However, it has long been acknowledged that microorganisms could be identified in distal airway secretions from patients with various respiratory diseases, including cystic fibrosis (CF) and non-CF bronchiectasis, chronic obstructive pulmonary disease, asthma and other chronic airway diseases (e.g.post-transplantation bronchiolitis obliterans). These microorganisms were sometimes considered as infectious agents that triggered host immune responses and contributed to disease onset and/or progression; alternatively, microorganisms were often considered as colonisers, which were considered unlikely to play roles in disease pathophysiology. These concepts were developed at a time when the identification of microorganisms relied on culture-based methods. Importantly, the majority of microorganisms cannot be cultured using conventional methods, and the use of novel culture-independent methods that rely on the identification of microorganism genomes has revealed that healthy distal airways display a complex flora called the airway microbiota. The present article reviews some aspects of current literature on host–microbe (mostly bacteria and viruses) interactions in healthy and diseased airways, with a special focus on distal airways.

scholarly journals A study on overview of asthma-chronic obstructive pulmonary disease overlaps among patients with obstructive airway diseases

2021 ◽  
Vol 6 (2) ◽  
pp. 117-120
Author(s):  
P Ajoy Kumar ◽  
Are Suryakari Sreekanth
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Age Difference ◽  
Obstructive Pulmonary Disease ◽  
Asthmatic Patients ◽  
Airway Diseases ◽  
Obstructive Airway Diseases ◽  
Chronic Airway

Asthma and chronic obstructive pulmonary disease (COPD) are different disease entities. They are both clinical diagnoses, with diagnostic tools to discriminate between one another.There is a need to re-evaluate the concept of asthma and chronic obstructive pulmonary disease (COPD) as separate conditions, and to consider situations when they may coexist, or when one condition may evolve into the other.  A prospective study included 70 patients with chronic airway diseases who were classified into three groups (COPD, asthma and ACO). They were selected from Department of Pulmonary Medicine, Kurnool Medical College outpatient clinic during the period from January 2019 to December 2019, where patients with COPD and ACO were diagnosed according to GOLD guidelines and patients with asthma were diagnosed according to GINA guidelines. Patients enrolled in the study were subjected to full history taking, clinical examination, full laboratory examination, plain chest radiography, spirometry before bronchodilator and after bronchodilator administration (reversibility test) and sputum analysis for counting eosinophils cells.  This study was conducted on 70 patients with chronic airway diseases (COPD, asthma and asthma COPD overlap) were selected. It included 47(67.1%) males and 23(32.8%) females. In our study, 30 (42.8%) patients as having COPD, 19(27.1%) patients were diagnosed as having asthma and 21(30%) patients were diagnosed as having ACO. Regarding the age difference between groups, it was found that patients who were diagnosed as having ACO were older than asthmatic patients with mean age of 49.43±5.83 and 47.23±6.73years, respectively. The men age of patients with COPD was 57.32±6.74 which was older than both ACO and asthmatic patients.  ACO represents a large percentage among patients with obstructive airway diseases. It shares some features of asthma such as atopy and positive sputum eosinophilia, and some features of COPD like old age of presentation and positive smoking history.

scholarly journals Decreased Eosinophil Counts and Elevated Lactate Dehydrogenase Predict Severe COVID-19 Patients with Underlying Chronic Airway Diseases

2020 ◽  
Author(s):  
Lingling Yi ◽  
Dian Chen ◽  
Shuchen Zhang ◽  
Yuchen Feng ◽  
Wenliang Wu ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Airway Inflammation ◽  
Chronic Bronchitis ◽  
Disease Severity ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Airway Diseases ◽  
New City ◽  
Eosinophil Counts ◽  
Chronic Airway

Abstract Background: Several predictors for the severity of coronavirus disease 2019 (COVID-19) have been reported, including decreased circulating lymphocytes and eosinophil counts. However, chronic airway inflammation characterized by accumulated lymphocytes or eosinophils may affect the pathogenesis of COVID-19. We aimed to investigate the predictors for the severity of COVID-19 in patients with chronic airway diseases.Methods: In this retrospective cohort study, we reviewed medical records of all laboratory-confirmed COVID-19 patients with chronic bronchitis, chronic obstructive pulmonary disease (COPD) and asthma admitted in Sino-French New City Branch of Tongji Hospital, a large regional hospital in Wuhan, China, from January 26th to April 3rd. The Tongji Hospital ethics committee approved this study.Results: There were 59 patients with underlying chronic airway inflammation including chronic bronchitis, COPD, and asthma. When compared with non-severe patients, severe patients were more likely to have decreased lymphocyte counts (0.6 vs. 1.1× 10⁹/L, p < 0.001), eosinopenia (< 0.02 × 10⁹/L, 73% vs. 24%, p < 0.001), increased lactate dehydrogenase (LDH) (471.0 vs. 230.0 U/L, p < 0.001) and elevated IL-6 level (47.4 vs. 5.7 pg/ml, p = 0.002) on admission. Eosinopenia and elevated LDH were significantly associated with disease severity in both univariate and multivariate regression models included the above variables. Eosinopenia was also an independent risk factor for mortality of this cohort in a multivariate model included the above variables. Moreover, eosinophil counts and LDH levels tended to return to normal range over time in both groups after treatment and severe patients recovered slower than non-severe patients, especially eosinophil counts.Conclusions: Eosinopenia and elevated LDH are potential predictors of disease severity in COVID-19 patients with underlying chronic airway diseases. Theses predictors may help clinicians identify the severe COVID-19 patients with chronic bronchitis, COPD, and asthma.

scholarly journals Conventional and Nanotechnology Based Approaches to Combat Chronic Obstructive Pulmonary Disease: Implications for Chronic Airway Diseases

2020 ◽  
Vol Volume 15 ◽  
pp. 3803-3826 ◽  
Author(s):  
Mehak Passi ◽  
Sadia Shahid ◽  
Sankarakuttalam Chockalingam ◽  
Isaac Kirubakaran Sundar ◽  
Gopinath Packirisamy
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Airway Diseases ◽  
Chronic Airway

scholarly journals Targeting Cytokines as Evolving Treatment Strategies in Chronic Inflammatory Airway Diseases

2018 ◽  
Vol 19 (11) ◽  
pp. 3402 ◽  
Author(s):  
Jaleesa Garth ◽  
Jarrod Barnes ◽  
Stefanie Krick
Keyword(s):  
Clinical Trials ◽  
Allergic Asthma ◽  
Inflammatory Marker ◽  
Interleukin 1 ◽  
Treatment Strategies ◽  
Bronchial Epithelium ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Airway Diseases ◽  
Novel Treatment Strategies

Cytokines are key players in the initiation and propagation of inflammation in chronic inflammatory airway diseases such as chronic obstructive pulmonary disease (COPD), bronchiectasis and allergic asthma. This makes them attractive targets for specific novel anti-inflammatory treatment strategies. Recently, both interleukin-1 (IL-1) and IL-6 have been associated with negative health outcomes, mortality and a pro-inflammatory phenotype in COPD. IL-6 in COPD was shown to correlate negatively with lung function, and IL-1beta was induced by cigarette smoke in the bronchial epithelium, causing airway inflammation. Furthermore, IL-8 has been shown to be a pro-inflammatory marker in bronchiectasis, COPD and allergic asthma. Clinical trials using specific cytokine blockade therapies are currently emerging and have contributed to reduce exacerbations and steroid use in COPD. Here, we present a review of the current understanding of the roles of cytokines in the pathophysiology of chronic inflammatory airway diseases. Furthermore, outcomes of clinical trials in cytokine blockade as novel treatment strategies for selected patient populations with those diseases will be discussed.

scholarly journals Precision Medicine in Interventional Cardiology

2020 ◽  
Vol 15 ◽  
Author(s):  
Thijmen W Hokken ◽  
Joana M Ribeiro ◽  
Peter P De Jaegere ◽  
Nicolas M Van Mieghem
Keyword(s):  
Precision Medicine ◽  
Therapeutic Option ◽  
Computational Modelling ◽  
Interventional Cardiology ◽  
Individual Therapy ◽  
Psychosocial Characteristics ◽  
Personal Variables ◽  
Test Treatments ◽  
The Individual ◽  
Genetic Biomarker

Precision medicine has recently become widely advocated. It revolves around the individual patient, taking into account genetic, biomarker, phenotypic or psychosocial characteristics and uses biological, mechanical and/or personal variables to optimise individual therapy. In silico testing, such as the Virtual Physiological Human project, is being promoted to predict risk and to test treatments and medical devices. It combines artificial intelligence and computational modelling to select the best therapeutic option for the individual patient.

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