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Title: | Personalized medicine for patients with COPD: where are we? | Authors: | Franssen, Frits M. E. Alter, Peter Bar, Nadav Benedikter, Birke J. Iurato, Stella Maier, Dieter Maxheim, Michael Roessler, Fabienne K. SPRUIT, Martijn A. Vogelmeier, Claus F. Wouters, Emiel F. M. Schmeck, Bernd |
Issue Date: | 2019 | Publisher: | DOVE MEDICAL PRESS LTD | Source: | International Journal of Chronic Obstructive Pulmonary Disease, 14, p. 1465-1484 | Abstract: | Chronic airflow limitation is the common denominator of patients with chronic obstructive pulmonary disease (COPD). However, it is not possible to predict morbidity and mortality of individual patients based on the degree of lung function impairment, nor does the degree of airflow limitation allow guidance regarding therapies. Over the last decades, understanding of the factors contributing to the heterogeneity of disease trajectories, clinical presentation, and response to existing therapies has greatly advanced. Indeed, diagnostic assessment and treatment algorithms for COPD have become more personalized. In addition to the pulmonary abnormalities and inhaler therapies, extra-pulmonary features and comorbidities have been studied and are considered essential components of comprehensive disease management, including lifestyle interventions. Despite these advances, predicting and/or modifying the course of the disease remains currently impossible, and selection of patients with a beneficial response to specific interventions is unsatisfactory. Consequently, non-response to pharmacologic and non-pharmacologic treatments is common, and many patients have refractory symptoms. Thus, there is an ongoing urgency for a more targeted and holistic management of the disease, incorporating the basic principles of P4 medicine (predictive, preventive, personalized, and participatory). This review describes the current status and unmet needs regarding personalized medicine for patients with COPD. Also, it proposes a systems medicine approach, integrating genetic, environmental, (micro) biological, and clinical factors in experimental and computational models in order to decipher the multilevel complexity of COPD. Ultimately, the acquired insights will enable the development of clinical decision support systems and advance personalized medicine for patients with COPD. | Notes: | [Franssen, Frits M. E.; Spruit, Martijn A.; Wouters, Emiel F. M.] CIRO, Dept Res & Educ, Horn, Netherlands. [Franssen, Frits M. E.; Spruit, Martijn A.; Wouters, Emiel F. M.] Maastricht Univ, Med Ctr, NUTRIM Sch Nutr & Translat Res Metab, Dept Resp Med, Maastricht, Netherlands. [Alter, Peter; Maxheim, Michael; Vogelmeier, Claus F.; Schmeck, Bernd] Philipps Univ Marburg UMR, Univ Med Ctr Giessen & Marburg, Dept Med Pulm & Crit Care Med, Marburg, Germany. [Alter, Peter; Maxheim, Michael; Vogelmeier, Claus F.; Schmeck, Bernd] German Ctr Lung Res DZL, Marburg, Germany. [Bar, Nadav; Roessler, Fabienne K.] Norwegian Univ Sci & Technol NTNU, Dept Chem Engn, Trondheim, Norway. [Benedikter, Birke J.] Univ Giessen, Inst Lung Res, Marburg, Germany. [Benedikter, Birke J.] Philipps Univ Marburg, Marburg Lung Ctr, Marburg, Germany. [Benedikter, Birke J.] MUMC, Dept Med Microbiol, Maastricht, Netherlands. [Iurato, Stella] Viscovery Software GmbH, Vienna, Austria. [Maier, Dieter] Biomax Informat AG, Planegg, Germany. [Spruit, Martijn A.] Hasselt Univ, Fac Rehabil Sci, BIOMED Biomed Res Inst, REVAL Rehabil Res Ctr, Diepenbeek, Belgium. | Keywords: | chronic obstructive pulmonary disease; personalized medicine; systems medicine; review;chronic obstructive pulmonary disease; personalized medicine; systems medicine; review | Document URI: | http://hdl.handle.net/1942/29159 | ISSN: | 1178-2005 | e-ISSN: | 1178-2005 | DOI: | 10.2147/COPD.S175706 | ISI #: | 000475992900001 | Rights: | This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2020 |
Appears in Collections: | Research publications |
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