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KMID : 1141720160040020009
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폐쇄성폐질환
2016 Volume.4 No. 2 p.9 ~ p.9
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Lee Jae-Seung
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Abstract
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Personalized medicine (PM) has received much attention in recent years after rapid developments in genomics which had enabled scientists and medical practitioners to develop personalized diagnosis and treatment. COPD is a complex disease with various clinical phenotypes; thus, there are likely to be drugs that are more or less effective for patients with a particular phenotype. Until now, frequent exacerbator, emphysema, chronic bronchitis and asthma-COPD overlap syndrome have been regarded as clinically relevant phenotypes which could be used for personalized treatment. A large amount of biomarkers has been evaluated in COPD patients. However, there are still no well validated biomarkers or surrogate endpoints that can be used to establish efficacy of novel drugs for COPD. Peripheral blood eosinophil and sputum eosoinophils may be a feature of ACOS, and have been shown to be associated with a positive response to corticosteroid treatment in patients with COPD. Recently, there has been increasing interest in developing CT-based biomarkers which can be used for predicting response to current and novel therapies. Combined assessment of lung volume and disease components of COPD with CT can be valuable decision-making tools in the lung volume reduction treatment. α1-antitrypsin deficiency provides an example of the significance of COPD subtypes in COPD pharmacogenetics. Molecular phenotyping of COPD through ‘omics’ data is likely to lead to an even more personalized pharmacological treatment of individual patients with COPD. An integrated approach will be critical for the development of genetic profiles based on the complex molecular mechanisms underlying treatment responses to eventually deliver truly precise and personalized medicine.
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KEYWORD
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COPD, Personalized medicine, Phenotype, Biomarker
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