Personalised medicine in asthma: time for action

Abstract

@ERSpublicationsWe need to start applying personalised medicine at all levels of severity of asthma http://ow.ly/EoXQ30e8p24 ABSTRACT Asthma is a heterogeneous disease comprising several phenotypes driven by different pathways. To define these phenotypes or endotypes ( phenotypes defined by mechanisms), an unbiased approach to clustering of various omics platforms will yield molecular phenotypes from which composite biomarkers can be obtained. Biomarkers can help differentiate between these phenotypes and pinpoint patients suitable for specific targeted therapies -the basis for personalised medicine. Biomarkers need to be linked to point-of-care biomarkers that may be measured readily in exhaled breath, blood or urine. The potential for using mobile healthcare approaches will help patient enpowerment, an essential tool for personalised medicine. Personalised medicine in asthma is not far off -it is already here, but we need more tools and implements to carry it out for the benefit of our patients.

A Bibliometric Analysis and Visualization of Medical Big Data Research

“…At the second position is review (98), with a proportion of 10.7%. Other document types including editorial material (36), proceedings paper (25), meeting abstract (12), book chapter (5), letter (2), book review (1), correction (1), news item (1). Table 1 lists the numbers and proportions of various document types.…”

Personalised medicine: are we ready?

“…As illustrated in the article in this issue of the ERR by CHUNG [1], asthma is certainly a shining example of a chronic disease for which the concept of phenotype has progressed the most over the last 20 years. This is partly due to the emergence of the technique of induced sputum, which has enabled the investigation of airway inflammation in large cohorts of patients with asthma.…”

“…As appropriately pointed out by CHUNG [1], personalised medicine in asthma should not be restricted to the severe spectrum of the disease and it is really time to also apply the principle to patients with mild to moderate disease. In this respect, without wishing to obscure the major therapeutic advance brought by ICS in asthma [23], there is compelling evidence showing that noneosinophilic asthmatics, defined as those having <2-3% eosinophils in their sputum cell count, respond poorly to ICS [2].…”

“…Thus, choices had to be made regarding the diseases or groups of diseases that needed to be addressed in this series. In addition to this first article on asthma [1], articles are planned for this series on the topics of personalised medicine in COPD, bronchiectasis including cystic fibrosis, lung cancer [26], interstitial lung disease, pulmonary vascular disorders, sleep disorders [27] and pulmonary rehabilitation. An additional article will develop the concept and reality of personalised medicine in the respiratory field.…”

Dismantling the pathophysiology of asthma using imaging

“…It is commonly described as a heterogeneous disorder, or alternatively a collection of separate conditions which lead to a common clinical picture. The heterogeneity of pathophysiology and clinical expression is becoming increasingly important in the era of "precision" or "personalised" medicine, where there is now strong evidence that treatment should not be a "one size fits all" approach [6][7][8]. The concept of "treatable traits" is increasingly recognised as an approach to managing airways disease that potentially leads to large clinical benefits, including improving asthma control [9].…”