Moving from the Oslerian paradigm to the post-genomic era: are asthma and COPD outdated terms?

L.E.G.W. Vanfleteren, J.W.H. Kocks, I.S. Stone, R. Breyer-Kohansal, T. Greulich, D. Lacedonia, R. Buhl, L.M. Fabbri, I.D. Pavord, N. Barnes, E.F.M. Wouters, A. Agusti

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

In the majority of cases, asthma and chronic obstructive pulmonary are two clearly distinct disease entities. However, in some patients significant overlap between the two conditions. This constitutes an area of concern because these patients are generally excluded from controlled trials (mostly because of smoking history in the case of because of significant bronchodilator reversibility in the case of result, their pathobiology, prognosis and response to therapy are unknown. This may lead to suboptimal management and can limit the more personalised therapeutic options. Emerging genetic and molecular coupled with new bioinformatics capabilities provide novel information pave the way towards a new taxonomy of airway diseases. In this paper we the current value of the terms 'asthma' and 'COPD' as still useful labels; discuss the scientific and clinical progress made over the past towards unravelling the complexity of airway diseases, from the clinical phenotypes and endotypes to a better understanding of cellular molecular networks as key pathogenic elements of human diseases (so- systems medicine); and summarise a number of ongoing studies with the to move the field towards a new taxonomy of airways diseases and, more personalised approach to medicine, in which the focus will shift current goal of treating diseases as best as possible to the so-called medicine, a new type of medicine that is predictive, preventive, participatory.
Original languageEnglish
Pages (from-to)72-79
Number of pages8
JournalThorax
Volume69
Issue number1
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • OBSTRUCTIVE PULMONARY-DISEASE
  • PLACEBO-CONTROLLED TRIAL
  • CLUSTER-ANALYSIS
  • AIRWAY DISEASE
  • LUNG-FUNCTION
  • DOUBLE-BLIND
  • PHENOTYPES
  • EXACERBATIONS
  • THERAPY
  • INDEX

Cite this

Vanfleteren, L. E. G. W., Kocks, J. W. H., Stone, I. S., Breyer-Kohansal, R., Greulich, T., Lacedonia, D., Buhl, R., Fabbri, L. M., Pavord, I. D., Barnes, N., Wouters, E. F. M., & Agusti, A. (2014). Moving from the Oslerian paradigm to the post-genomic era: are asthma and COPD outdated terms? Thorax, 69(1), 72-79. https://doi.org/10.1136/thoraxjnl-2013-203602