Personalizing and targeting therapy for COPD – the role of molecular and clinical biomarkers

Abstract

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease characterized by persistent airflow limitation. It is the third leading cause of death worldwide, and there are currently no curative strategies for this disease. Many factors contribute to COPD susceptibility, progression and exacerbations. These include cigarette smoking, environmental and occupational pollutants, respiratory infections and comorbidities. As the clinical phenotypes of COPD are so variable, it has been difficult to devise an individualized treatment plan for patients with this complex chronic disease. This review will highlight how potential clinical, inflammatory, genomic and epigenomic biomarkers for COPD could be used to personalize treatment, leading to improved disease management and prevention for our patients.

Keywords::

• biomarkers
• chronic obstructive pulmonary disease
• clinical
• diagnosis
• molecular
• genomic
• treatment

Acknowledgments

The authors sincerely thank the patients and staff of The Prince Charles Hospital for their participation in our research program.

Financial & competing interests disclosure

This work was supported by NHMRC project grants: NHMRC Career Development Fellowship (IA Yang), NHMRC Practitioner Fellowship (KM Fong), Queensland Health and Medical Research project grants, The Prince Charles Hospital Foundation and ARC Discovery Grant (IA Yang). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Chronic obstructive pulmonary disease (COPD) is a heterogeneous group of pulmonary and extra-pulmonary disease manifestations rather than a single disease.

• • Biomarkers for specific aspects of COPD disease susceptibility, progression, complications and comorbidities may be clinically useful to identify and monitor COPD disease phenotypes and mechanisms for targeted prevention and management.

• • At present, these biomarkers are putative and require detailed prospective validation in clinical trials of diagnosis, prevention, prognosis and treatment of COPD, before successful translation to the clinic and to clinical guidelines.

Notes