In the last of a 4-part series, Augustine M.K. Choi, MD, Stephen and Suzanne Weiss Dean of Weill Cornell Medicine in New York City speaks with Pulmonology Advisor about the asthma/COPD overlap syndrome and the advantages of precision medicine.
Pulmonology Advisor: Does asthma/COPD overlap syndrome represent a distinct clinical phenotype of asthma and COPD? How might one disease evolve into the other?
The debate about the overlap between asthma and COPD has been around for several decades. There are intriguing data supporting that these are 2 distinct diseases, but there are also supporting data that there is some overlap. It boils down to the clinical phenotype that these diseases manifest, and ongoing research in the community is trying to address whether there is a subset of patients with the clinical phenotype with overlapping syndromes or overlapping symptoms of asthma and COPD. It is an exciting area of research. Although there is a lot more to do, I suspect that in the near future, we will better understand the different phenotypes, and hopefully be able to target different treatments in the era of precision medicine to treat patients with asthma or emphysema.
Pulmonology Advisor: Could you expand on precision medicine and discuss what may be in the pipeline or currently in use? How would the therapeutic intervention change, based on that diagnosis?
Well, we are living in an exciting postgenomic era, and with precision medicine, we are now not only able to diagnose and treat diseases but we can actually precisely predict the patients who are more susceptible to disease and, importantly, who will respond to treatment. At Weill Cornell, like many of our peer institutions, we have established a robust program in precision medicine, mostly in cancer but also in noncancer diseases. So these are exciting times for all of us in the community, and we will continue to do that at Weill Cornell Medicine. Going forward, our medical students will be living in an era where precise treatment based on your genomics will dictate what type of treatment you have for certain indications.
Chronic lung disease ranks third in terms of morbidity and mortality worldwide, including the United States, after cancer and cardiovascular deaths. We are really poised to use the most state-of-the-art approaches, whether genomics or other “-omics,” to better understand the pathogenesis of disease, but most important, to identify diagnostic and therapeutic targets in the future in the lung diseases. As pulmonologists, we are going to do all we can to advance the cause. Here at Weill Cornell Medicine, we have a strong program in lung disease that will contribute to the community.
Disclosures: Dr. Choi is the cofounder of Proterris, a company that aims to develop CO therapeutically.