This review outlines a new, personalized approach for the classification and management of airway diseases. The current approach to airways disease is, we believe, no longer fit for purpose. It is impractical, overgeneralizes complex and heterogeneous conditions and results in management that is imprecise and outcomes that are worse than they could be. Importantly, the assumptions we make when applying a diagnostic label have impeded new drug discovery and will continue to do so unless we change our approach. This review suggests a new mechanism-based approach where the emphasis is on identification of key causal mechanisms and targeted intervention with treatment based on possession of the relevant mechanism rather than an arbitrary label. We highlight several treatable traits and suggest how they can be identified and managed in different healthcare settings.
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May 2017
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Image demonstrates the ultrastructural cortical basement membrane changes in SHRSP brain: accumulation of lipofuscin in pericytes. For further details, see article by Screiber et al in this issue (pages 1001–1013). Image kindly provided by Stefanie Schreiber.
Review Article|
May 09 2017
A new approach to the classification and management of airways diseases: identification of treatable traits
Rahul Shrimanker;
Rahul Shrimanker
1Nuffield Department of Medicine, NDM Research Building, University of Oxford, Oxford OX3 7FZ, U.K.
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Xue Ning Choo;
Xue Ning Choo
1Nuffield Department of Medicine, NDM Research Building, University of Oxford, Oxford OX3 7FZ, U.K.
2Changi General Hospital, 2 Simei Street 3, Singapore 529889
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Ian D. Pavord
1Nuffield Department of Medicine, NDM Research Building, University of Oxford, Oxford OX3 7FZ, U.K.
Correspondence: Ian Pavord ([email protected])
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Publisher: Portland Press Ltd
Received:
October 18 2016
Revision Received:
December 14 2016
Accepted:
January 26 2017
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2017 The Author(s). published by Portland Press Limited on behalf of the Biochemical Society
2017
Clin Sci (Lond) (2017) 131 (10): 1027–1043.
Article history
Received:
October 18 2016
Revision Received:
December 14 2016
Accepted:
January 26 2017
Citation
Rahul Shrimanker, Xue Ning Choo, Ian D. Pavord; A new approach to the classification and management of airways diseases: identification of treatable traits. Clin Sci (Lond) 1 May 2017; 131 (10): 1027–1043. doi: https://doi.org/10.1042/CS20160028
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