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Vol. 46. Issue S11.
Aspectos relevantes en EPOC
Pages 8-11 (December 2010)
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Vol. 46. Issue S11.
Aspectos relevantes en EPOC
Pages 8-11 (December 2010)
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Fenotipos clínicos de la EPOC
Clinical phenotypes of COPD
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Patricia Sobradilloa, Judith García-Aymerichb,c,d,e, Àlvar Agustía,f,g,h,
Corresponding author
alvar.agusti@clinic.ub.es

Autor para correspondencia.
a CIBER en Enfermedades Respiratorias (CIBERES), Mallorca, España
b Centro de Investigación en Epidemiología Ambiental (CREAL), Barcelona, España
c Instituto Municipal de Investigación Médica (IMIM-Hospital del Mar), Barcelona, España
d CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España
e Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, España
f Fundación Caubet Cimera, Mallorca, España
g Servicio de Neumología, Instituto del Tórax, Hospital Clínic, Barcelona
h Institut D’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
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Resumen

La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad compleja, multicomponente. Su presentación clínica es muy heterogénea, por lo que es posible que dentro de lo que hoy denominamos EPOC haya grupos (fenotipos) de pacientes con características clínicas y/o biológicas comunes que tengan pronósticos diferentes y/o precisen abordajes terapéuticos diferentes. Aunque, en sentido amplio, fenotipo es cualquier característica observable de un organismo, un “fenotipo clínico” es “una característica o conjunto de características de la enfermedad que es/son capaces de diferenciar individuos con EPOC y que tienen relación con outcomes (consecuencias) clínicas relevantes, como síntomas, exacerbaciones, respuesta al tratamiento, progresión de la enfermedad o muerte”. En este artículo se revisa el estado actual de conocimiento en este ámbito.

Palabras clave:
Bronquitis crónica
Enfisema
Inflamación
Abstract

chronic obstructive pulmonary disease (COPD) is a complex, multifaceted disease. The clinical presentation is highly heterogeneous and consequently, within what is known today as COPD, there may be some groups (phenotypes) of patients who share clinical and/or biological characteristics but who have distinct prognoses and/or who require different therapeutic approaches. In its broadest sense, phenotype is defined as any observable characteristic in the body, but “clinical phenotpe” is defined as a characteristic or set of chacteristics of a disease that can be used to distinguish individuals with COPD and are related to significant clinical outcomes, such as symptoms, exacerbations, treatment response, disease progression or death. The present article reviews current knowledge of this topic.

Keywords:
Chronic bronchitis
Emphysema
Inflammation
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Bibliografía
[1.]
F. Rabe K, S. Hurd, A. Anzueto, P.J. Barnes, S.A. Buist, P. Calverley, et al.
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.
Am J Respir Crit Care Med, 176 (2007), pp. 532-555
[2.]
G. Peces-Barba, J.A. Barberá, A. Agustí, C. Casanova, A. Casas, J.L. Izquierdo, et al.
Diagnosis and management of chronic obstructive pulmonary disease: joint guidelines of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Latin American Thoracic Society (ALAT).
Arch Bronconeumol, 44 (2008), pp. 271-281
[3.]
Peces-Barba G, Barberá JA, Agustí, Casanova C, Casas A, Izquierdo JL, et al. Guía clínica de diagnóstico y tratamiento de la enfermedad pulmonar obstructiva crónica. SEPAR-ALAT; 2007.
[4.]
A.G. Agustí.
COPD, a multicomponent disease: implications for management.
Respir Med, 99 (2005), pp. 670-682
[5.]
A. Agustí, P. Calverley, B. Celli, H. Coxson, L. Edwards, D. Lomas, et al.
Characterisation of COPD heterogeneity in the ECLIPSE cohort.
Respiratory Research, 11 (2010), pp. 122-136
[6.]
S.I. Rennard, J. Vestbo.
The many “small COPDs”: COPD should be an orphan disease.
Chest, 134 (2008), pp. 623-627
[7.]
García-Aymerich J, Gómez F, Benet M, Farrero E, Basagana X, Gayete A, et al. Identification and prospective validation of clincally relevant chronic obstructive pulmonary disease (COPD) subtypes. Thorax. En prensa 2010.
[8.]
J. Vestbo, W. Anderson, H.O. Coxson, C. Crim, F. Dawber, L. Edwards, et al.
Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE).
Eur Respir J, 31 (2008), pp. 869-873
[9.]
Burgel PR, Paillasseur JL, Caillaud D, Tillie-Leblond I, Chanez P, Escamilla R, et al. Clinical COPD phenotypes: a novel approach using principal component and cluster analyses. Eur Respir J. En prensa 2010.
[10.]
M.H. Cho, G.R. Washko, T.J. Hoffmann, G.J. Criner, E.A. Hoffman, F.J. Martínez, et al.
Cluster analysis in severe emphysema subjects using phenotype and genotype data: an exploratory investigation.
Respir Res, 11 (2010), pp. 30
[11.]
E.A. Regan, J.E. Hokanson, J.R. Murphy, B. Make, D.A. Lynch, T.H. Beaty, et al.
Genetic epidemiology of COPD (COPDGene) study design.
[12.]
N. Freimer, C. Sabatti.
The human phenome project.
Nat Genet, 34 (2003), pp. 15-21
[13.]
Agustí A, Sobradillo P, Celli B. Addressing the complexity of COPD: from phenotypes and biomarkers to scale-free networks, systems biology and P4 medicine. Am J Respir Crit Care Med. En prensa 2010.
[14.]
M.K. Han, A. Agustí, P.M. Calverley, B.R. Celli, G. Criner, J.L. Curtis, et al.
Chronic Obstructive Pulmonary Disease Phenotypes: The Future of COPD.
Am J Respir Crit Care Med, 182 (2010), pp. 598-604
[15.]
J. Vestbo, S. Rennard.
Chronic obstructive pulmonary disease biomarker(s) for disease activity needed-urgently.
Am J Respir Crit Care Med, 182 (2010), pp. 863-864
[16.]
S.E. Marsh, J. Travers, M. Weatherall, M.V. Williams, S. Aldington, P.M. Shirtcliffe, et al.
Proportional classifications of COPD phenotypes.
Thorax, 63 (2008), pp. 761-767
[17.]
S. Bhattacharya, S. Srisuma, D.L. DeMeo, S.D. Shapiro, R. Bueno, E.K. Silverman, et al.
Molecular biomarkers for quantitative and discrete COPD phenotypes.
Am J Respir Cell Mol Biol, 40 (2009), pp. 359-367
[18.]
P.W. Jones, A.GN. Agusti.
Outcomes and markers in the assessment of chronic obstructive pulmonary disease.
Eur Respir J, 27 (2006), pp. 822-832
[19.]
A.C. Dornhorst.
Respiratory insufficiency.
Lancet, 268 (1995), pp. 1185-1187
[20.]
Report of the Medical Research Council Working Party.
Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema.
Lancet, (1981), pp. 681-685
[21.]
Nocturnal Oxygen Therapy Trial Group.
Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease. A clinical trial.
Ann Intern Med, 93 (1980), pp. 391-398
[22.]
D. Górecka, K. Gorzelak, P. Sliwinski, M. Tobiasz, J. Zielinski.
Effect of long term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxaemia.
Thorax, 52 (1997), pp. 674-679
[23.]
J. Zielinski.
Long-term oxygen therapy in COPD patients with moderate hypoxaemia: does it add years to life?.
Eur Respir J, 12 (1998), pp. 756-758
[24.]
National Emphysema Treatment Trial Research Group.
A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema.
N Engl J Med, 348 (2003), pp. 2059-2073
[25.]
L.M. Fabbri, P.M. Calverley, J.L. Izquierdo-Alonso, D.S. Bundschuh, M. Brose, F.J. Martínez, et al.
Roflumilast in moderate-to-severe chronic obstructive pulmonary disease treated with longacting bronchodilators: two randomised clinical trials.
[26.]
P.M. Calverley, K.F. Rabe, U.M. Goehring, S. Kristiansen, L.M. Fabbri, F.J. Martínez.
Roflumilast in symptomatic chronic obstructive pulmonary disease: two randomised clinical trials.
[27.]
J. García-Aymerich, F.P. Gómez, J.M. Antó.
Phenotypic characterization and course of chronic obstructive pulmonary disease in the PAC-COPD study: design and methods.
Arch Bronconeumol, 45 (2009), pp. 4-11
[28.]
J.R. Hurst, J. Vestbo, A. Anzueto, N. Locantore, H. Ullerova, R. Tal-Singer, et al.
2010. Susceptibility to exacerbation in chronic obstructive pulmonary disease.
N Engl J Med, 363 (2010), pp. 1128-1138
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