Abstract：
To date, the treatable traits (TTs) approach has been applied in the context of managing diagnosed diseases. TTs are clinical characteristics and risk factors that can be identified clinically and/or biologically, and that merit treatment if present. There has been an exponential increase in the uptake of this approach by both researchers and clinicians. Realizing the potential of the TTs approach to pre-clinical disease, this expert review proposes that it is timely to consider acting on TTs present before a clinical diagnosis is made, which might help to prevent development of the full disease. Such an approach is ideal for diseases where there is a long pre-clinical phase, such as in chronic obstructive pulmonary disease (COPD). The term \'pre-COPD\' has been recently proposed to identify patients with respiratory symptoms and/or structural or functional abnormalities without airflow limitation. They may eventually develop airflow limitation with time but patients with pre-COPD are likely to have traits that are already treatable. This review first outlines the contribution of recently generated knowledge into lifetime lung function trajectories and the conceptual framework of \'GETomics\' to the field of pre-COPD. GETomics is a dynamic and cumulative model of interactions between genes and the environment throughout the lifetime that integrates information from multi-omics to understand aetiology and mechanisms of diseases. This review then discusses the current evidence on potential TTs in pre-COPD patients and makes recommendations for practice and future research. At a broader level, this review proposes that introducing the TTs in pre-COPD may help reenergize the preventive approaches to health and diseases.
摘要：
迄今为止,可治疗性状（TT）方法已应用于管理诊断疾病的背景下。TTs是临床特征和风险因素，可以在临床和/或生物学上识别，如果存在，那就值得治疗。研究人员和临床医生对这种方法的吸收呈指数增长。意识到TTs方法对临床前疾病的潜力，这份专家审查建议，在做出临床诊断之前，考虑对在场的TT采取行动是及时的，这可能有助于防止整个疾病的发展。这种方法对于有很长的临床前阶段的疾病是理想的，例如慢性阻塞性肺疾病（COPD）。最近提出了术语“pre-COPD”用于识别具有呼吸道症状和/或结构或功能异常而没有气流限制的患者。随着时间的推移，他们最终可能会出现气流受限，但COPD前期患者可能具有已经可以治疗的特征。这篇综述首先概述了最近产生的知识对终生肺功能轨迹的贡献以及“GETomics”概念框架对COPD前领域的贡献。GETomics是整个生命周期中基因与环境之间相互作用的动态和累积模型，它整合了来自多组学的信息以了解疾病的病因和机制。然后，这篇综述讨论了当前关于COPD前期患者潜在TTs的证据，并对实践和未来研究提出了建议。在更广泛的层面上，这篇综述提出,在COPD前期引入TT可能有助于重新激发健康和疾病的预防方法.
