Inhaled Volume as a Digital Biomarker Predicting Outcomes in Chronic Respiratory Disease.

IF 2 4区 医学 Q3 RESPIRATORY SYSTEM
Henry Chrystyn, Mark Milton-Edwards
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引用次数: 0

Abstract

Inhaler-based digital biomarkers can be objectively evaluated to indicate changes in response to therapeutic interventions. In chronic respiratory disease (CRD), measures of exhaled airflow play a central role in diagnosis and management, yet inhaled measures have not. Digital inhalers can passively collect inspiratory parameters such as inhaled volume (InhV) and peak inspiratory flow (PIF) during real-life patient use. Emphasis has been directed to the PIF, but little is known about the role of the InhV. InhV has now been observed to decrease prior to an exacerbation of asthma or chronic obstructive pulmonary disease and increase afterwards and be lower in uncontrolled asthma patients. These observations are consistent with the current understanding of the pathophysiology of CRD, whereby a strong correlation between InhV and forced expiratory volume in one second has been observed. Measurement of InhV has demonstrated accuracy and low variability, supporting the validity of interpreting individualized trends over time. After counseling, patient inhalation technique decays over time, and it is InhV that decreases more than PIF. Together, these findings suggest that InhV, captured by a digital inhaler, has utility as an effective digital biomarker to aid management of patients with CRD, with InhV being a major factor in the predictive value with respect to acute exacerbations.

吸入量作为预测慢性呼吸系统疾病预后的数字生物标志物。
基于吸入器的数字生物标志物可以客观地评估,以指示对治疗干预的反应变化。在慢性呼吸系统疾病(CRD)中,呼出气流测量在诊断和管理中起着核心作用,而吸入气流测量则没有。数字吸入器可以被动地收集患者在实际使用过程中的吸入量(InhV)和吸气峰值流量(PIF)等吸气参数。重点已指向PIF,但对InhV的作用知之甚少。目前已观察到InhV在哮喘或慢性阻塞性肺病加重前降低,加重后升高,在未控制的哮喘患者中降低。这些观察结果与目前对CRD病理生理学的理解是一致的,即观察到InhV与一秒钟用力呼气量之间存在很强的相关性。InhV的测量已经证明了准确性和低变异性,支持了解释个性化趋势随时间的有效性。咨询后,患者吸入技术随着时间的推移而衰减,而InhV的衰减大于PIF。总之,这些发现表明,通过数字吸入器捕获的InhV作为一种有效的数字生物标志物,可以帮助管理CRD患者,而InhV是急性加重预测价值的主要因素。
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来源期刊
CiteScore
6.70
自引率
2.90%
发文量
34
审稿时长
>12 weeks
期刊介绍: Journal of Aerosol Medicine and Pulmonary Drug Delivery is the only peer-reviewed journal delivering innovative, authoritative coverage of the health effects of inhaled aerosols and delivery of drugs through the pulmonary system. The Journal is a forum for leading experts, addressing novel topics such as aerosolized chemotherapy, aerosolized vaccines, methods to determine toxicities, and delivery of aerosolized drugs in the intubated patient. Journal of Aerosol Medicine and Pulmonary Drug Delivery coverage includes: Pulmonary drug delivery Airway reactivity and asthma treatment Inhalation of particles and gases in the respiratory tract Toxic effects of inhaled agents Aerosols as tools for studying basic physiologic phenomena.
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