Moving from the Oslerian paradigm to the post-genomic era: are asthma and COPD outdated terms?

In the majority of cases, asthma and chronic obstructive pulmonary disease (COPD) are two clearly distinct disease entities. However, in some patients there may be significant overlap between the two conditions. This constitutes an important area of concern because these patients are generally exclu...

Szczegółowa specyfikacja

Opis bibliograficzny
Główni autorzy: Vanfleteren, L, Kocks, J, Stone, I, Breyer-Kohansal, R, Greulich, T, Lacedonia, D, Buhl, R, Fabbri, L, Pavord, I, Barnes, N, Wouters, E, Agusti, A
Format: Journal article
Język:English
Wydane: 2014
_version_ 1826307274600087552
author Vanfleteren, L
Kocks, J
Stone, I
Breyer-Kohansal, R
Greulich, T
Lacedonia, D
Buhl, R
Fabbri, L
Pavord, I
Barnes, N
Wouters, E
Agusti, A
author_facet Vanfleteren, L
Kocks, J
Stone, I
Breyer-Kohansal, R
Greulich, T
Lacedonia, D
Buhl, R
Fabbri, L
Pavord, I
Barnes, N
Wouters, E
Agusti, A
author_sort Vanfleteren, L
collection OXFORD
description In the majority of cases, asthma and chronic obstructive pulmonary disease (COPD) are two clearly distinct disease entities. However, in some patients there may be significant overlap between the two conditions. This constitutes an important area of concern because these patients are generally excluded from randomised controlled trials (mostly because of smoking history in the case of asthma or because of significant bronchodilator reversibility in the case of COPD). As a result, their pathobiology, prognosis and response to therapy are largely unknown. This may lead to suboptimal management and can limit the development of more personalised therapeutic options. Emerging genetic and molecular information coupled with new bioinformatics capabilities provide novel information that can pave the way towards a new taxonomy of airway diseases. In this paper we question the current value of the terms 'asthma' and 'COPD' as still useful diagnostic labels; discuss the scientific and clinical progress made over the past few years towards unravelling the complexity of airway diseases, from the definition of clinical phenotypes and endotypes to a better understanding of cellular and molecular networks as key pathogenic elements of human diseases (so-called systems medicine); and summarise a number of ongoing studies with the potential to move the field towards a new taxonomy of airways diseases and, hopefully, a more personalised approach to medicine, in which the focus will shift from the current goal of treating diseases as best as possible to the so-called P4 medicine, a new type of medicine that is predictive, preventive, personalised and participatory.
first_indexed 2024-03-07T07:00:27Z
format Journal article
id oxford-uuid:ff91b4d8-02c9-42f9-afc6-b0d14cefa4b5
institution University of Oxford
language English
last_indexed 2024-03-07T07:00:27Z
publishDate 2014
record_format dspace
spelling oxford-uuid:ff91b4d8-02c9-42f9-afc6-b0d14cefa4b52022-03-27T13:45:56ZMoving from the Oslerian paradigm to the post-genomic era: are asthma and COPD outdated terms?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ff91b4d8-02c9-42f9-afc6-b0d14cefa4b5EnglishSymplectic Elements at Oxford2014Vanfleteren, LKocks, JStone, IBreyer-Kohansal, RGreulich, TLacedonia, DBuhl, RFabbri, LPavord, IBarnes, NWouters, EAgusti, AIn the majority of cases, asthma and chronic obstructive pulmonary disease (COPD) are two clearly distinct disease entities. However, in some patients there may be significant overlap between the two conditions. This constitutes an important area of concern because these patients are generally excluded from randomised controlled trials (mostly because of smoking history in the case of asthma or because of significant bronchodilator reversibility in the case of COPD). As a result, their pathobiology, prognosis and response to therapy are largely unknown. This may lead to suboptimal management and can limit the development of more personalised therapeutic options. Emerging genetic and molecular information coupled with new bioinformatics capabilities provide novel information that can pave the way towards a new taxonomy of airway diseases. In this paper we question the current value of the terms 'asthma' and 'COPD' as still useful diagnostic labels; discuss the scientific and clinical progress made over the past few years towards unravelling the complexity of airway diseases, from the definition of clinical phenotypes and endotypes to a better understanding of cellular and molecular networks as key pathogenic elements of human diseases (so-called systems medicine); and summarise a number of ongoing studies with the potential to move the field towards a new taxonomy of airways diseases and, hopefully, a more personalised approach to medicine, in which the focus will shift from the current goal of treating diseases as best as possible to the so-called P4 medicine, a new type of medicine that is predictive, preventive, personalised and participatory.
spellingShingle Vanfleteren, L
Kocks, J
Stone, I
Breyer-Kohansal, R
Greulich, T
Lacedonia, D
Buhl, R
Fabbri, L
Pavord, I
Barnes, N
Wouters, E
Agusti, A
Moving from the Oslerian paradigm to the post-genomic era: are asthma and COPD outdated terms?
title Moving from the Oslerian paradigm to the post-genomic era: are asthma and COPD outdated terms?
title_full Moving from the Oslerian paradigm to the post-genomic era: are asthma and COPD outdated terms?
title_fullStr Moving from the Oslerian paradigm to the post-genomic era: are asthma and COPD outdated terms?
title_full_unstemmed Moving from the Oslerian paradigm to the post-genomic era: are asthma and COPD outdated terms?
title_short Moving from the Oslerian paradigm to the post-genomic era: are asthma and COPD outdated terms?
title_sort moving from the oslerian paradigm to the post genomic era are asthma and copd outdated terms
work_keys_str_mv AT vanfleterenl movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms
AT kocksj movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms
AT stonei movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms
AT breyerkohansalr movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms
AT greulicht movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms
AT lacedoniad movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms
AT buhlr movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms
AT fabbril movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms
AT pavordi movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms
AT barnesn movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms
AT wouterse movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms
AT agustia movingfromtheoslerianparadigmtothepostgenomiceraareasthmaandcopdoutdatedterms