摘要
呼吸道疾病包括慢性阻塞性肺病(COPD)在内正在全球性增长,预计截至2020年COPD将会成为全球死亡率的第三大原因。CDPD是一种异质性疾病,由于受基因、环境和生活习惯等多种复杂因素相互作用的影响,COPD病人表现出不同的显性。近些年,为了确定这些相互作用,做了一些调查研究,但是,对于导致显性的鉴别仍然有些困难,并且也许会导致对COPD不充分的评估和治疗(通常仅仅依赖于气流受限参数FEV1的严重程度)。在这种新的方案中,COPD的治疗已经面向一种全面综合的途径发展。这种复杂程度要求分析基于大的资料组(也包括先进的功能基因组分析)和新的计算生物学方法(对提取相关临床决策过程和新药研发非常必要)。因此,根据出现的系统网络医药,考虑到多重网络的扰动如基因和环境变化,COPD应该被重新评估。病人广泛表征的系统医药(SM)平台,提供了更多靶向临床途径基础,它具有预测性、预防性、个性化和参与性(“P4医药”)。它明确表明在不久的未来,新的机会将会使关于稀有COPD模式的临床研究和新的标志物对伴随疾病、严重程度和发展性的鉴别变为可能。在此,我们对文章进行了总结,讨论了采用SM 方案治疗COPD带来的机遇,关注于蛋白质组学和代谢组学,为了改善开发更有效的治疗方式。
关键词: COPD
Current Medicinal Chemistry
Title:Novel Therapeutic Strategy in the Management of COPD: A Systems Medicine Approach
Volume: 22 Issue: 32
Author(s): Filippo Lococo, Alfredo Cesario, Alessandra Del Bufalo, Alessia Ciarrocchi, Giulia Prinzi, Marco Mina, Stefano Bonassi and Patrizia Russo
Affiliation:
关键词: COPD
摘要: Respiratory diseases including chronic-obstructive-pulmonary-disease (COPD) are globally increasing, with COPD predicted to become the third leading cause of global mortality by 2020. COPD is a heterogeneous disease with COPD-patients displaying different phenotypes as a result of a complex interaction between various genetic, environmental and life-style factors. In recent years, several investigations have been performed to better define such interactions, but the identification of the resulting phenotypes is still somewhat difficult, and may lead to inadequate assessment and management of COPD (usually based solely on the severity of airflow limitation parameter FEV1). In this new scenario, the management of COPD has been driven towards an integrative and holistic approach. The degree of complexity requires analyses based on large datasets (also including advanced functional genomic assays) and novel computational biology approaches (essential to extract information relevant for the clinical decision process and for the development of new drugs). Therefore, according to the emerging “systems/network medicine”, COPD should be re.-evaluated considering multiple network(s) perturbations such as genetic and environmental changes. Systems Medicine (SM) platforms, in which patients are extensively characterized, offer a basis for a more targeted clinical approach, which is predictive, preventive, personalized and participatory (“P4-medicine”). It clearly emerges that in the next future, new opportunities will become available for clinical research on rare COPD patterns and for the identification of new biomarkers of comorbidity, severity, and progression. Herein, we overview the literature discussing the opportunity coming from the adoption of SMapproaches in COPD management, focusing on proteomics and metabolomics, and emphasizing the identification of disease sub-clusters, to improve the development of more effective therapies.
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Filippo Lococo, Alfredo Cesario, Alessandra Del Bufalo, Alessia Ciarrocchi, Giulia Prinzi, Marco Mina , Stefano Bonassi and Patrizia Russo , Novel Therapeutic Strategy in the Management of COPD: A Systems Medicine Approach, Current Medicinal Chemistry 2015; 22 (32) . https://dx.doi.org/10.2174/0929867322666150904113032
DOI https://dx.doi.org/10.2174/0929867322666150904113032 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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