Comorbidities as treatable traits of chronic airway diseases

Abstract

Chronic airway diseases, including asthma, chronic obstructive pulmonary disease, and bronchiectasis, are increasingly recognized as heterogeneous conditions influenced not only by airway pathology but also by a wide range of extrapulmonary and behavioral comorbidities. The treatable traits (TT) model, as it has emerged in recent medical literature, offers a precision medicine framework that redefines comorbidities as clinically relevant, identifiable, and modifiable traits. This paradigm shifts the focus from conventional disease labels to a multidimensional approach that considers the individual's unique constellation of pulmonary, extrapulmonary, and psychosocial features. A growing body of research has identified critical targets for intervention. The efficacy of this approach is supported by evidence from clinical trials and real-world studies. These studies demonstrate that trait-based management, especially when incorporating comorbidities, results in improved disease control, reduced symptom burden, enhanced quality of life, and decreased frequency of exacerbations. The implementation of multidimensional assessment tools and multidisciplinary care models is imperative for operationalizing this strategy within both primary and secondary care settings. Future directions for this field include leveraging artificial intelligence and machine learning to refine trait identification and predict individualized treatment responses. Longitudinal studies and adaptive trial designs are also necessary to evaluate the long-term effectiveness, cost-efficiency, and scalability of trait-based interventions across diverse healthcare systems. The recognition of comorbidities as TTs signifies a substantial advancement in the delivery of holistic, patient-centered care for individuals with chronic airway diseases.