The role of precision medicine in bronchiectasis: emerging data and clinical implications.

Autores de IIS La Fe

• Grace Jacqueline Oscullo Yépez

  Autor

• 

  Miguel Ángel Martínez García

  Autor

Participantes ajenos a IIS La Fe

• de la Rosa, David
• Garcia Clemente, Marta
• Giron, Rosa
• Golpe, Rafael
• Maiz, Luis

Grupos

• Neumología

  

  Leader

  Miguel Ángel Martínez García

Abstract

INTRODUCTION: Bronchiectasis is a very heterogeneous disease. This heterogeneity has several consequences: severity cannot be measured by a single variable, so multidimensional scores have been developed to capture it more broadly. Some groups of patients with similar clinical characteristics or prognoses (clinical phenotypes), and even similar inflammatory profiles (endotypes), have been identified, and these have been shown to require a more specific treatment. AREAS COVERED: We comment on this 'stratified' model of medicine as an intermediate step toward the application of the usual concepts on which precision medicine is based (such as cellular, molecular or genetic biomarkers, treatable traits and individual clinical fingerprinting), whereby each subject presents certain specific characteristics and receives individualized treatment. EXPERT OPINION: True precision or personalized medicine is based on concepts that have not yet been fully achieved in bronchiectasis, although some authors are already beginning to adapt them to this disease in terms of pulmonary and extrapulmonary etiologies, clinical fingerprinting (specific to each individual), cellular biomarkers such as neutrophils and eosinophils (in peripheral blood) and molecular biomarkers such as neutrophil elastase. In therapeutic terms, the future is promising, and some molecules with significant antibiotic and anti-inflammatory properties are being developed.

Keywords

• Bronchiectasis; endotype; eosinophil; neutrophil; personalized medicine; phenotype; precision medicine; traitable trait