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¿Qué significa el endotipado para el tratamiento de la enfermedad pulmonar obstructiva crónica?

Alvar Agustí¹, Bartolome Celli², Rosa Faner³

¹Respiratory Institute, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain; CIBER Enfermedades Respiratorias, Madrid, Spain.

Lancet (London, England)

|September 6, 2017

Resumen

La medicina de precisión para la enfermedad pulmonar obstructiva crónica (EPOC) requiere comprender los endotipos de la enfermedad. La integración de datos de alto rendimiento con la biología de sistemas puede identificar biomarcadores para el diagnóstico y tratamiento de la EPOC a medida.

Área de la Ciencia:

Medicina de los pulmones
Biología de sistemas
Medicina de la red

Sus antecedentes:

La enfermedad pulmonar obstructiva crónica (EPOC) es clínica y biológicamente compleja y heterogénea.
El diagnóstico y el tratamiento actuales de la EPOC se basan en medidas clínicas simples, no en la patobiología subyacente.
Hay una necesidad de avanzar hacia la medicina de precisión para la EPOC.

Objetivo del estudio:

Proponer una nueva taxonomía de la EPOC basada en mecanismos patobiológicos (endotipos).
Explorar el papel de los endotipos, los biomarcadores y los fenotipos en la EPOC.
Discutir cómo la biología de sistemas y la medicina de redes pueden avanzar en la comprensión y el tratamiento de la EPOC.

Principales métodos:

Integración e interpretación de datos de alto rendimiento utilizando bioinformática, biología de sistemas y medicina de redes.
Identificación de los endotipos de EPOC y sus biomarcadores asociados.
Analizar las lagunas de conocimiento en la patobiología de la EPOC.

Principales resultados:

Se propone una nueva taxonomía para la EPOC basada en los endotipos.
La biología de sistemas y la medicina de redes ofrecen herramientas para identificar endotipos y biomarcadores específicos de la EPOC.
Los enfoques basados en el endotipo pueden mejorar la precisión, la efectividad y la seguridad de los tratamientos de EPOC.

Conclusiones:

La medicina de precisión en la EPOC requiere un cambio de tratamiento generalizado a estrategias específicas del endotipo.
Comprender la heterogeneidad de la EPOC a través de endotipos y biomarcadores es crucial para avanzar en la atención al paciente.
La medicina de sistemas y redes es clave para desbloquear el potencial de la medicina de precisión en la EPOC.

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