Chronic obstructive pulmonary disease: phenotypes and endotypes, comorbidities and personalized therapeutic approach (a systematic review)
Keywords:
COPD, Phenotypes, endotypes, comorbiditiesAbstract
Chronic Obstructive Pulmonary Disease (COPD) is a multisystem and heterogeneous disease that remains under-diagnosed and undervalued overall, as one of the diseases with increased morbidity and mortality. At this time, COPD is accepted as a heterogeneous condition consisting of multiple endotypes and phenotypes. In addition to known and already widely accepted COPD phenotypes, new phenotypes of chronic obstructive pulmonary disease are also emerging. The presence of significant comorbidities is likely to be one of the most significant risk factors for the severity of COPD, most COPD patients have at least one comorbid condition, making the course and management of the disease more difficult. The main goal of identifying phenotypes is to provide patients with the best possible medical care, adapting the individualized therapeutic approach, both, non-pharmacological and pharmacological, according to symptoms, exacerbations, lung function, and inevitably comorbidities.
References
1. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD).
2. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global Strategy Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary. în Am J Respir Crit Care Med. 2017;195(5):557-582. https://doi.org/10.1164/rccm.201701-0218PP
3. Ecaterina, S., et al., în Comorbidităţiile în bronhopneumopatia cronică obstructivă (revista literaturii). în Вестник Академии Наук Молдовы. Медицина, 2021. 69(1): p. 165-169.
4. Miller, Joy et al. "Comorbidity, systemic inflammation and outcomes in the ECLIPSE cohort." în Respiratory medicine vol. 107,9 (2013): 1376-84. doi:10.1016/j. rmed.2013.05.001. Cavaillès, A., et al., Comorbidities of COPD. în Eur Respir Rev, 2013. 22(130): p. 454-75. https://doi.org/10.1183/09059180.00008612
6. Corlateanu A, Covantev S, Mathioudakis AG, Botnaru V, Siafakas N. Prevalence and burden of comorbidities in Chronic Obstructive Pulmonary Disease. în Respir Investig. 2016;54(6):387-396. https://doi.org/10.1016/j.resinv.2016.07.001
7. Barnes PJ. Inflammatory endotypes in COPD. în Allergy Eur J Allergy Clin Immunol. 2019;74(7):1249-1256. https://doi.org/10.1111/all.13760
8. Corlateanu A, Mendez Y, Wang Y, Garnica R de JA, Botnaru V, Siafakas N. "Chronic obstructive pulmonary disease and phenotypes: a state-of-the-art." în Pulmonology. 2020;26(2):95-100. https://doi.org/10.1016/j.pulmoe.2019.10.006
9. Nikolaou V, Massaro S, Fakhimi M, Stergioulas L, Price D. COPD phenotypes and machine learning cluster analysis: A systematic review and future research agenda. în Respir Med. 2020;171. https://doi.org/10.1016/j.rmed.2020.106093
10. Henao MP, Craig TJ. Understanding alpha‐1 antitrypsin defi‐ciency: a review with an allergist's outlook. în Allergy Asthma Proc. 2 0 17;3 8 : 9 8 ‐107.
11. Barnes PJ. Inflammatory endotypes in COPD. în Allergy Eur J Allergy Clin Immunol. 2019;74(7):1249-1256. https://doi.org/10.1111/all.13760
12. Joseph Loscalzo în HARRISON'S PULMONARY AND CRITICAL CARE MEDICINE, SECOND EDITION 2017.
13. Chapman KR, Chorostowska‐Wynimko J, Koczulla AR, Ferrarotti I, McElvaney NG. Alpha‐1 antitrypsin to treat lung disease in alpha1antitrypsin deficiency: recent developments and clinical implica‐tions. în Int J Chron Obstruct Pulmon Dis. 2018;13:419‐432. https://doi.org/10.2147/COPD.S149429
14. Sze MA, Dimitriu PA, Suzuki M, et al. Host response to the lung microbiome in chronic obstructive pulmonary disease. în Am J Respir Crit Care Med. 2015;192(4):438-445. https://doi.org/10.1164/rccm.201502-0223OC
15. Katzenstein, Anna-Luise A et al. "Diagnosis of usual interstitial pneumonia and distinction from other fibrosing interstitial lung diseases." în Human pathology vol. 39,9 (2008): 1275-94. https://doi.org/10.1016/j.humpath.2008.05.009
16. Barnes, Peter J. "Cellular and molecular mechanisms of asthma and COPD." în Clinical science (London, England : 1979) vol. 131,13 (2017): 1541-1558. https://doi.org/10.1042/CS20160487
17. Carolan, Brendan J, and E Rand Sutherland. "Clinical phenotypes of chronic obstructive pulmonary disease and asthma: recent advances." în The Journal of allergy and clinical immunology vol. 131,3 (2013): 627-34; quiz 635. https://doi.org/10.1016/j.jaci.2013.01.010
18. Zeki AA, Jarjour NN. The Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome: A New Take on an Old Concept. în Ann Am Thorac Soc. 2016 Sep;13(9):1440-2. PMID: 27627469; PMCID: PMC5059506. https://doi.org/10.1513/AnnalsATS.201606-493ED
19. Tho, Nguyen Van et al. "Asthma-COPD overlap syndrome (ACOS): A diagnostic challenge." în Respirology (Carlton, Vic.) vol. 21,3 (2016): 410-8. https://doi.org/10.1111/resp.12653
20. Gerhardsson De Verdier M, Andersson M, Kern DM, Zhou S, Tunceli O. Asthma and Chronic Obstructive Pulmonary Disease Overlap Syndrome: Doubled Costs Compared with Patients with Asthma Alone. în Value Heal. 2015;18(6):759-766. https://doi.org/10.1016/j.jval.2015.04.010
21. Papi, A et al. "Partial reversibility of airflow limitation and increased exhaled NO and sputum eosinophilia in chronic obstructive pulmonary disease." în American journal of respiratory and critical care medicine vol. 162,5 (2000): 1773-7. https://doi.org/10.1164/ajrccm.162.5.9910112
22. Negewo NA, McDonald VM, Baines KJ, Wark PA, Simpson JL, Jones PW, Gibson PG. Peripheral blood eosinophils: a surrogate marker for airway eosinophilia in stable COPD. în Int J Chron Obstruct Pulmon Dis. 2016 Jul 1;11:1495-504. https://doi.org/10.2147/COPD.S100338
23. Fragoso E, André S, Boleo-Tomé JP, Areias V, Munhá J, Cardoso J. Understanding COPD: A vision on phenotypes, comorbidities and treatment approach. în Rev Port Pneumol (English Ed. 2016;22(2):101-111. https://doi.org/10.1016/j.rppnen.2015.12.001
24. Vazquez Guillamet R, Ursu O, Iwamoto G, Moseley PL, Oprea T. Chronic obstructive pulmonary disease phenotypes using cluster analysis of electronic medical records în Health Informatics J. 2018;24(4):394-409. https://doi.org/10.1177/1460458216675661
25. O'Donnell, Denis E et al. "Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease - 2007 update." în Canadian respiratory journal vol. 14 Suppl B,Suppl B (2007): 5B-32B. https://doi.org/10.1155/2007/830570
26. Miravitlles, Marc et al. "Spanish guideline for COPD (GesEPOC). Update 2014." în Archivos de bronconeumologia vol. 50 Suppl 1 (2014): 1-16. https://doi.org/10.1016/S0300-2896(14)70070-5
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
