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Targeting Chronic Obstructive Pulmonary Disease Phenotypes, Endotypes, and Biomarkers
Suresh Garudadri1, Prescott G Woodruff2,3
11 Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio; and.
Annals of the American Thoracic Society
|February 14, 2019
Summary
Chronic obstructive pulmonary disease (COPD) is biologically diverse. Identifying specific COPD endotypes using biomarkers can guide targeted therapies for better patient outcomes.
Area of Science:
- Pulmonology
- Immunology
- Genetics
Background:
- Chronic obstructive pulmonary disease (COPD) exhibits significant phenotypic heterogeneity.
- This heterogeneity is driven by underlying biological differences among patients.
- The endotype concept aims to classify COPD patients based on shared biological mechanisms.
Purpose of the Study:
- To explore the concept of endotypes in COPD.
- To discuss the role of biomarkers in identifying COPD endotypes.
- To highlight the potential for targeted therapies based on endotype classification.
Main Methods:
- Review of current literature on COPD heterogeneity and endotypes.
- Discussion of established and potential COPD endotypes, including alpha-1 antitrypsin deficiency and eosinophilic COPD.
- Exploration of biomarkers associated with different biological pathways in COPD.
Main Results:
- Alpha-1 antitrypsin deficiency and eosinophilic COPD are well-defined endotypes with biomarkers and evidence for targeted therapy.
- Other potential endotypes involve type 2 inflammation, IL-17-driven inflammation, bacterial colonization, and mucus alterations.
- The precise classification into distinct endotypes versus treatable traits is still under investigation.
Conclusions:
- The endotype concept is crucial for understanding COPD's biological heterogeneity.
- Biomarkers are essential for identifying endotypes and enabling personalized treatment strategies.
- Advancing biomarker development will facilitate the creation of novel COPD therapies.
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