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

2. 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

3. 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

4. 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: /
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

5. 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

6. 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

7. 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

8. 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

9. 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