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Personalisierte Medizin bei pulmonaler Hypertonie

Personalized medicine in pulmonary hypertension

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Die pulmonale Hypertonie ist eine heterogene Gruppe von Erkrankungen, welche über den erhöhten mittleren pulmonal-arteriellen Druck definiert ist. Die personalisierte Medizin zielt darauf ab, die Therapie individuell auf den Patienten und seine Krankheitscharakteristika abzustimmen und so die Therapieansprache und das Ergebnis zu verbessern. Im vorliegenden Artikel werden aktuelle und zukünftige Ansätze zur Implementierung der personalisierten Medizin bei der pulmonalen Hypertonie dargestellt. Durch die Anwendung der ätiologischen Klassifikation, die Vasoreagibilitätstestung, die Risikostratifizierung, die genetische Testung, aber auch die Berücksichtigung klinischer Charakteristika wie Alter und Geschlecht wird eine Personalisierung der Therapie bereits heute angewendet. In Zukunft könnten auch pharmakogenetische Untersuchungen helfen, das Ansprechen auf bestehende und neue medikamentöse Therapien vorherzusagen. Mit Hilfe der „Omics“-Technologien werden heute neue Erkenntnisse nicht nur im Bereich des Genoms und Transkriptoms sondern auch des Epigenoms, Metaboloms und Proteoms gewonnen. Diese könnten künftig eine weitere Unterteilung der Patientengruppen und die Entwicklung neuer personalisierter Therapien erlauben.

Abstract

Pulmonary hypertension is a heterogeneous group of diseases that is characterized by an increased mean pulmonary arterial pressure. Personalized medicine aims to individualize the treatment to the characteristics of the patient and the disease in order to improve the response to treatment and the outcome. This article describes the current and future approaches for implementation of personalized medicine for pulmonary hypertension. By use of the etiological classification, vasoreactivity testing, risk stratification, genetic testing and also consideration of clinical characteristics, such as age and sex, a personalization of treatment is already being applied. In the future pharmacogenetic investigations could help to predict the response to existing and new medical treatments. Using omics technologies new insights are gained not only in the area of the genome and transcriptome but also the epigenome, metabolome and proteome. These insights could be used for further subclassification of patient groups and development of new personalized treatments.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik V, LMU – Klinikum der Universität München, Comprehensive Pneumology Center Munich (CPC-M), Marchioninistr. 15, 81377, München, Deutschland

    K. Milger-Kneidinger

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K. Milger-Kneidinger gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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J. Behr, München

E. von Mutius, München

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Milger-Kneidinger, K. Personalisierte Medizin bei pulmonaler Hypertonie. Pneumologe 16, 76–87 (2019). https://doi.org/10.1007/s10405-018-0227-1

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