Pulmonology in the era of 4P medicine

Charles Pilette, Antoine Froidure, Audrey Hanson, Thierry Pieters Published in the journal : February 2020 Category : Pneumology

Summary :

Pulmonology has entered the era of so-called "4P" medicine, which is meant to be preventive, personalized, predictive, and participatory. Combating smoking and improving air quality are essential for the prevention of most respiratory diseases. The summary of innovations we offer in the fields of asthma, lung cancer, and interstitial lung disease clearly illustrates the concepts of predictive and personalized medicine. Health care now takes into account not only observable characteristics, such as asthma with sinus polyposis or non-small cell cancer, but also the mechanisms involved in their pathophysiology, such as eosinophils in asthma or PD1 / PD-L1 expression in lung cancer. All this underlies the concept of endotype. Finally, the patient is offered the appropriate treatment based on biomarkers. We also benefit from recent advances in genetics. In addition to the search for predictive rearrangements underlying the response to certain chemotherapies, the discovery of common genetic variants associated with pulmonary fibrosis will enable us to predict its evolution, or even more, prevent its occurrence by promoting preventive measures within risk groups. Finally, the inclusion of patients in the care process optimizes adherence to treatment and control of the disease, while feeding research in our University Clinics to better understand and treat medical conditions in the near future.

Key Words

Pulmonology, 4 P medicine, smoking, air quality, pulmonary fibrosis