Journal article
Toward a predict and prevent approach in obstructive airway diseases
- Abstract:
- Asthma and chronic obstructive pulmonary disease are currently diagnosed and treated after the demonstration of variable airflow limitation and symptoms. Under this framework, undiagnosed and unchecked airway inflammation is associated with recurrent acute attacks, airway remodeling, airflow limitation, adverse effects of corticosteroids, and impaired quality of life, ultimately leading to the collection of side effects termed “people remodeling.” This one-size-fits-all damage control approach aims to control symptoms and treat exacerbations rather than modify the underlying disease process. The advent of highly effective therapies targeting proximal drivers of airway inflammation calls for a paradigm shift; upstream-acting therapies offer potential to alter the disease course and achieve clinical remission. We propose moving away from downstream firefighting and toward a “predict and prevent” model, measuring inflammation and providing anti-inflammatory therapy early, without waiting for further clinical deterioration. Much in the same way that high blood pressure and cholesterol are used to predict and prevent heart attacks, in asthma, elevated blood eosinophils and/or exhaled nitric oxide can be used to predict and prevent asthma attacks. We also advocate moving research further upstream by identifying patients with subclinical airway inflammation or disease who may be at risk of progressing to airflow limitation and associated morbidities and intervening early to prevent them. In summary, we call for a predict and prevent approach in obstructive airway disease.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
-
-
(Preview, Accepted manuscript, pdf, 1.7MB, Terms of use)
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- Publisher copy:
- 10.1016/j.jaip.2023.01.008
Authors
- Publisher:
- Elsevier
- Journal:
- Journal of Allergy and Clinical Immunology: In Practice More from this journal
- Volume:
- 11
- Issue:
- 3
- Pages:
- 704-712
- Publication date:
- 2023-01-20
- Acceptance date:
- 2023-01-05
- DOI:
- EISSN:
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2213-2198
- Pmid:
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36682536
- Language:
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English
- Keywords:
- Pubs id:
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1329377
- Local pid:
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pubs:1329377
- Deposit date:
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2025-01-02
Terms of use
- Copyright holder:
- American Academy of Allergy, Asthma & Immunology
- Copyright date:
- 2023
- Rights statement:
- © 2023 American Academy of Allergy, Asthma & Immunology
- Notes:
- This is the accepted manuscript version of the article. The final version is available online from Elsevier at https://dx.doi.org/10.1016/j.jaip.2023.01.008
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