What is relevant for primary care in the U-BIOPRED?

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Presentation transcript:

What is relevant for primary care in the U-BIOPRED? Dr Hilary Pinnock General Practitioner, Whitstable, Kent, UK Reader, University of Edinburgh

All severe asthma is not the same SIMPLES This course is supported by an unrestricted educational grant from U-BIOPRED Any opinions expressed are those of the faculty, not U-BIOPRED

All severe asthma is not the same U-BIOPRED (Unbiased BIOmarkers in PREDiction of respiratory disease outcomes) Understand severe asthma phenotypes Base management on individual phenotype Target new therapies Personalised medicine This course is supported by an unrestricted educational grant from U-BIOPRED Any opinions expressed are those of the faculty, not U-BIOPRED

All severe asthma is not the same ‘omics Wheelock et al. Application of ‘omics technologies to biomarker discovery in inflammatory lung diseases. ERJ Express doi: 10.1183/09031936.00078812 transcriptomics, proteomics lipidomics metabolomics ‘breathomics’ Hypothesis generating ..to identify biomarkers that define disease This course is supported by an unrestricted educational grant from U-BIOPRED Any opinions expressed are those of the faculty, not U-BIOPRED

All severe asthma is not the same More than half of patients with severe asthma in tertiary care have adult-onset disease with a distinct phenotype (Hekking et al) Oral steroid dependent asthma patients have higher inflammatory markers and may be steroid resistant (Gibeon et al, Chung et al) Oral steroid-dependent asthmatics had a higher BMI, lower serum IgE and blood eosinophils, and a tendency for more ex-smokers (Chung et al) Persistent airflow limitation is associated with male gender, lower age of onset, low BMI, raised lymphocyte count and a range of other biomarkers (Wagener et al) ..to identify biomarkers that define disease This course is supported by an unrestricted educational grant from U-BIOPRED Any opinions expressed are those of the faculty, not U-BIOPRED U-BIOPRED abstracts at the ATS 2014, ERS 2014

All severe asthma is not the same Define ‘fingerprints’ – generate hypotheses Integrate data to formulate biologically plausible models Refine the model using theoretical and statistical modeling: distinguish between competing hypotheses, assess sensitivity, specificity and stability Test the ‘handprint’ hypotheses ..to identify biomarkers that define disease This course is supported by an unrestricted educational grant from U-BIOPRED Any opinions expressed are those of the faculty, not U-BIOPRED Auffray et al. An Integrative Systems Biology Approach to Understanding Pulmonary Diseases. Chest 2010; 137: 1410 – 1416

All severe asthma is not the same Test the ‘handprint’ hypotheses ..to identify biomarkers that define disease This course is supported by an unrestricted educational grant from U-BIOPRED Any opinions expressed are those of the faculty, not U-BIOPRED Auffray et al. An Integrative Systems Biology Approach to Understanding Pulmonary Diseases. Chest 2010; 137: 1410 – 1416

All severe asthma is not the same SIMPLES Primary care clinics Severe asthma clinics Use defined phenotypes to inform management This course is supported by an unrestricted educational grant from U-BIOPRED Any opinions expressed are those of the faculty, not U-BIOPRED

All severe asthma is not the same This course is supported by an unrestricted educational grant from U-BIOPRED Any opinions expressed are those of the faculty, not U-BIOPRED