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Vol. 46. Issue 8.
Pages 433-438 (January 2010)
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Vol. 46. Issue 8.
Pages 433-438 (January 2010)
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Why do We Look at Asthma through the Keyhole?
¿Por qué miramos el asma a través del ojo de la cerradura?
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Miguel Perpiñá Tordera
Servicio de Neumología, Hospital Universitario La Fe, Valencia, Spain
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Abstract

As happens with the rest of pathology, the study of asthma has been traditionally conducted from postulates set by reductionist science. That model still provides answers to theoretical and practical questions that establish diseases, but does not offer us a complete view of their complexity and multidimensionality. To overcome this limitation has emerged medicine directed towards systems based on the application of biological systems concepts and tools. Biological systems is a cross-disciplinary strategy which, from the data generated by the “-omic” sciences, helps to relate the elements of an organism or biological system, to understand the properties arising from the same and to generate mathematical models capable of predicting their dynamic behaviour. The application of biological systems to asthma starts is starting to make ground. The main challenge today is to understand the need to change focus. The starting point is to abandon the idea that asthma is exclusively an airways disease and considering that the whole lung is involved and, even more, the possibility that it is, at least in part, a systemic process. In view of our current limitations, to understand asthma and design personalised treatment strategies for each patient, requires thinking of systems medicine.

Keywords:
Asthma
Systems oriented medicine
Biology systems
Omic sciences
Resumen

Al igual que sucede con el resto de la patología, el estudio del asma se ha venido realizando tradicionalmente desde los postulados marcados por la ciencia reduccionista. Ese modelo sigue aportando respuestas a las preguntas teóricas y prácticas que las enfermedades plantean pero no nos ofrece una visión completa de su complejidad y multidimensionalidad. Para superar esta limitación surge la medicina orientada hacia sistemas basada en la aplicación de los conceptos y herramientas de la biología de sistemas. La biología de sistemas es una estrategia analítica transdisciplinar que, a partir de los datos generados por las ciencias ómicas, permite relacionar los elementos de un organismo o sistema biológico, comprender las propiedades emergentes del mismo y generar modelos matemáticos capaces de predecir su comportamiento dinámico. La aplicación de la biología de sistemas al asma comienza a dar ya los primeros pasos. Hoy el reto principal es comprender la necesidad del cambio de enfoque. El punto de partida pasa por abandonar la idea del asma como enfermedad exclusiva de la vía aérea considerando que en su patogenia participa todo el pulmón y, aún más, que posiblemente se trate, al menos en parte, de un proceso sistémico. Vistas nuestras limitaciones actuales, entender el asma y diseñar estrategias terapéuticas personalizadas para cada paciente exige pensar en medicina de sistemas.

Palabras clave:
Asma
Medicina orientada hacia sistemas
Biología de sistemas
Ciencias ómicas
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El contenido del presente artículo está basado en la conferencia del mismo título pronunciada por el autor durante el XXXV Simposio de Neumología (octubre 2009).

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