The value of treatable traits across the spectrum of adult asthma severity

Wenwen Wu , Vanessa M. McDonald , Gang Wang , Peter Gerard Gibson
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引用次数: 0

Abstract

Asthma is a heterogeneous condition characterized by diverse clinical phenotypes and variable treatment responses, underscoring the limitations of the traditional “one-size-fits-all” stepwise management paradigm. The treatable traits (TTs) approach, a precision medicine framework, targets individualized, clinically relevant characteristics spanning pulmonary, extrapulmonary, and behavioral domains. This review synthesizes current evidence on the prevalence and impact of TTs across the spectrum of asthma severity—mild, moderate, and severe. Although severe asthma is associated with a greater overall burden of TTs, patients with mild-to-moderate disease frequently present with substantial trait-related challenges, including persistent symptoms and exacerbations. Key traits, such as eosinophilic inflammation, fixed airflow limitation, obesity, gastroesophageal reflux disease, and psychological comorbidities, vary in prevalence yet exert influence across all severity strata. Super-traits, including T2 inflammation and suboptimal inhaler adherence, warrant prioritization owing to their broad therapeutic implications. Optimal implementation requires tailored strategies in both primary and tertiary care, supported by multidisciplinary collaboration, patient engagement, and resource-efficient diagnostic tools. While barriers include limited clinician awareness and integration into existing workflows, enablers such as decision aids and structured education can facilitate adoption. The TTs model represents a promising pathway toward personalized asthma care, with the potential to improve outcomes across all severities.
跨越成人哮喘严重程度谱的可治疗特征的价值
哮喘是一种异质性疾病,其特点是不同的临床表型和不同的治疗反应,强调了传统的“一刀切”逐步管理模式的局限性。可治疗特征(TTs)方法是一种精准医学框架,针对个性化的临床相关特征,涵盖肺、肺外和行为领域。这篇综述综合了目前在哮喘严重程度(轻度、中度和重度)范围内ttt的患病率和影响的证据。虽然严重哮喘与更大的总结核结核负担相关,但轻至中度疾病患者经常出现与体征相关的重大挑战,包括持续症状和恶化。关键特征,如嗜酸性粒细胞炎症、固定气流限制、肥胖、胃食管反流疾病和心理合并症,在患病率上各不相同,但对所有严重程度的人群都有影响。由于其广泛的治疗意义,包括T2炎症和次优吸入器依从性在内的超级特征值得优先考虑。最佳实施需要在初级和三级保健中制定量身定制的战略,并得到多学科合作、患者参与和资源高效诊断工具的支持。虽然障碍包括有限的临床医生意识和对现有工作流程的整合,但决策辅助和结构化教育等推动因素可以促进采用。TTs模型代表了个性化哮喘护理的一个有希望的途径,有可能改善所有严重程度的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Chinese medical journal pulmonary and critical care medicine
Chinese medical journal pulmonary and critical care medicine Critical Care and Intensive Care Medicine, Infectious Diseases, Pulmonary and Respiratory Medicine
CiteScore
0.40
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0.00%
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