Treatable traits: a comprehensive precision medicine in interstitial lung disease.
Yet Hong KhorVincent CottinAnne Elizabeth HollandYoshikazu InoueVanessa M McDonaldJustin OldhamElisabetta A RenzoniAnne -Marie RussellMary E StrekChristopher J RyersonPublished in: The European respiratory journal (2023)
Interstitial lung disease (ILD) is a diverse group of inflammatory and fibrotic lung conditions causing significant morbidity and mortality. A multitude of factors beyond the lungs influence symptoms, health-related quality of life, disease progression, and survival in patients with ILD. Despite an increasing emphasis on multidisciplinary management in ILD, the absence of a framework for assessment and delivery of comprehensive patient care poses challenges in clinical practice. The treatable traits approach is a precision medicine care model that operates on the premise of individualised multidimensional assessment for distinct traits that can be targeted by specific interventions. The potential utility of this approach has been described in airway diseases but has not been adequately considered in ILD. Given the similar disease heterogeneity and complexity between ILD and airway diseases, we explore the concept and potential application of the treatable traits approach in ILD. A framework of aetiological, pulmonary, extra-pulmonary, and behavioural and lifestyle treatable traits relevant to clinical care and outcomes for patients with ILD is proposed. We further describe key research directions to evaluate the application of the treatable traits approach towards advancing patient care and health outcomes in ILD.
Keyphrases
- interstitial lung disease
- systemic sclerosis
- idiopathic pulmonary fibrosis
- rheumatoid arthritis
- genome wide
- healthcare
- pulmonary hypertension
- clinical practice
- palliative care
- physical activity
- quality improvement
- dna methylation
- metabolic syndrome
- cardiovascular disease
- insulin resistance
- type diabetes
- skeletal muscle
- risk assessment
- depressive symptoms
- cancer therapy
- climate change
- human health