Developing Biomarkers in Precision Medicine for Asthma and COPD

There is a growing demand for the implementation of precision medicine. There is an urgent need to move away from one-size-fits-all medicine, in which the treatment is based on the disease name alone, and to implement a precision-medicine approach. Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) require a precision-medicine approach. Asthma and COPD are heterogeneous disorders with various phenotypes. In order to characterize the pathological features of a patient, it is important to analyze not only the phenotype, but also the molecular mechanisms underlying the clinical features, called endotypes. It is crucial to customize the treatment of the disease according to both the phenotype and endotype. Therefore, developing biomarkers enabling treatment stratification is essential to the practice of precision medicine. This approach of finding optimal treatment by identifying patient features using biomarkers is known as a treatable-traits approach. We conducted clinical and basic studies to identify patients with COPD who could be treated with asthma medications and to identify the pathological features of patients with COPD and asthma (asthma-COPD overlap: ACO). We identified several blood proteins and microRNAs that have potential for be clinically useful as biomarkers for customizing treatment in patients with ACO.