Summary

The Module I contains some preliminary basic element that allow to introduce the concept and perspective of Treatable Traits in Respiratory Diseases.

Professor Alberto Papi from Ferrara University opened the discussions on treatable traits (TTs) by reviewing the evidence in chronic obstructive lung disease (COPD). Prof. Papi emphasised the disease’s heterogeneous nature, which leads to the need for personalising therapy to the patient’s specifically treatable problems, the core of the TT concept. Clinically relevant, identifiable, measurable, and treatable, TTs are not mutually exclusive but can coexist in the same COPD patients; moreover, TTs can be variable over the patient’s life course. International documents like GOLD already recognise the modern TT concept.

Prof. Alvar Agustí from Barcelona University focused on the related issue of some persisting semantic ambiguities about COPD. Do the Pre-COPD, Young COPD, Early COPD, and PRISm labels identify different TTs? As Prof. Agustí magistrally clarified, all those labels identify nosologically diversified conditions, while agnostic TTs are independent of specific clinical entities.

Professor Wisia Wedzicha of the Imperial College in London discussed how to prevent exacerbations, a specific COPD TT responsible for at least 25% of the FEV₁ decline, with a severe risk in GOLD 1- and GOLD-2 patients. Professor Wedzicha emphasised how two symptoms of chronic bronchitis, chronic cough and mucus hypersecretion, are especially significant early predictors of exacerbations.