Phenotyping the heterogeneity of chronic obstructive pulmonary disease

被引:37
作者
Barker, Bethan L. [1 ]
Brightling, Christopher E. [1 ]
机构
[1] Univ Leicester, Inst Lung Hlth, Dept Infect Immun & Inflammat, Leicester LE3 9QP, Leics, England
关键词
chronic obstructive pulmonary disease (COPD); computed tomography imaging (CT imaging); genome-wide association; inflammation; remodelling; NONTYPABLE HAEMOPHILUS-INFLUENZAE; AIR-FLOW OBSTRUCTION; PDE4 INHIBITOR ROFLUMILAST; ENDOTHELIAL GROWTH-FACTOR; SHORT-TERM RESPONSE; CHRONIC-BRONCHITIS; EPITHELIAL-CELLS; ACUTE EXACERBATIONS; OXIDATIVE STRESS; CT DENSITOMETRY;
D O I
10.1042/CS20120340
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
100103 [病原生物学]; 100218 [急诊医学];
摘要
COPD (chronic obstructive pulmonary disease) is a heterogeneous disease associated with significant morbidity and mortality. Current diagnostic criteria based on the presence of fixed airflow obstruction and symptoms do not integrate the complex pathological changes occurring within lung, do not define different airway inflammatory patterns, nor do they define different physiological changes or differences in structure as can be defined by imaging. Over recent years, there has been interest in describing this heterogeneity and using this information to subgroup patients into COPD phenotypes. Most approaches to phenotyping have considered disease at a single scale and have not integrated information from different scales (e.g. organ-whole person, tissue-organ, cell-tissue and gene cell) of disease to provide multi-dimensional phenotypes. Integration of disease biology with clinical expression is critical to improve understanding of this disease. When combined with biostatistical modelling, this information may lead to identification of new drug targets, new end points for clinical trials and targeted treatment for subgroups of COPD patients. It is hoped this will ultimately improve COPD outcomes and represent a move towards personalised medicine. In the present review, we will consider these aspects of multi-dimensional phenotyping in more detail.
引用
收藏
页码:371 / 387
页数:17
相关论文
共 115 条
[1]
Granulocyte inflammatory markers and airway infection during acute exacerbation of chronic obstructive pulmonary disease [J].
Aaron, SD ;
Angel, JB ;
Lunau, M ;
Wright, K ;
Fex, C ;
Le Saux, N ;
Dales, RE .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2001, 163 (02) :349-355
[2]
ABBOUD RT, 1985, AM REV RESPIR DIS, V131, P79
[3]
Lymphocyte proliferative response to P6 of Haemophilus influenzae is associated with relative protection from exacerbations of chronic obstructive pulmonary disease [J].
Abe, Y ;
Murphy, TF ;
Sethi, S ;
Faden, HS ;
Dmochowski, J ;
Harabuchi, Y ;
Thanavala, YM .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2002, 165 (07) :967-971
[4]
Persistent Systemic Inflammation is Associated with Poor Clinical Outcomes in COPD: A Novel Phenotype [J].
Agusti, Alvar ;
Edwards, Lisa D. ;
Rennard, Stephen I. ;
MacNee, William ;
Tal-Singer, Ruth ;
Miller, Bruce E. ;
Vestbo, Jorgen ;
Lomas, David A. ;
Calverley, Peter M. A. ;
Wouters, Emiel ;
Crim, Courtney ;
Yates, Julie C. ;
Silverman, Edwin K. ;
Coxson, Harvey O. ;
Bakke, Per ;
Mayer, Ruth J. ;
Celli, Bartolome .
PLOS ONE, 2012, 7 (05)
[5]
Addressing the Complexity of Chronic Obstructive Pulmonary Disease From Phenotypes and Biomarkers to Scale-Free Networks, Systems Biology, and P4 Medicine [J].
Agusti, Alvar ;
Sobradillo, Patricia ;
Celli, Bartolome .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2011, 183 (09) :1129-1137
[6]
The clinical applications of a systems approach [J].
Ahn, Andrew C. ;
Tewari, Muneesh ;
Poon, Chi-Sang ;
Phillips, Russell S. .
PLOS MEDICINE, 2006, 3 (07) :956-960
[7]
The limits of reductionism in medicine: Could systems biology offer an alternative? [J].
Ahn, Andrew C. ;
Tewari, Muneesh ;
Poon, Chi-Sang ;
Phillips, Russell S. .
PLOS MEDICINE, 2006, 3 (06) :709-713
[8]
[Anonymous], BURD LUNG DIS STAT R
[9]
[Anonymous], 2010, CHRON OBSTR PULM DIS
[10]
[Anonymous], GLOB STRAT DIAGN MAN