{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:21:15Z","timestamp":1792023675792,"version":"4.4.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"Supplement_4","license":[{"start":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T00:00:00Z","timestamp":1543622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic obstructive pulmonary disease (COPD) is now well recognized to be a phenotypically heterogeneous disease, and this heterogeneity is underpinned by biological heterogeneity. An \u201cendotype\u201d is a group of patients who share the same observed characteristic(s) because of shared underlying biology, and the \u201cendotype\u201d concept has emerged as one way of bringing order to this phenotypic heterogeneity by focusing on its biological underpinnings. In principle, biomarkers can help identify endotypes and mark these specific groups of patients as suitable candidates for targeted biological therapies. Among the better-described endotypes of COPD are alpha-1 antitrypsin deficiency and eosinophilic COPD. Both of these endotypes have biomarkers and at least some evidence of preferential benefit from targeted therapy. Other biological pathways that may define endotypes of COPD include more general pathways of type 2 inflammation, IL-17\u2013driven inflammation (due to autoimmunity or deposition of nanoparticulate carbon black), bacterial colonization, pathological alterations of the airway mucus gel, and others that are beyond the scope of this review. Whether these biological pathways ultimately are found to segregate patients into very distinct endotypes or subsets (like alpha-1 antitrypsin deficiency) or, instead, are present as \u201ctreatable traits\u201d in various combinations is uncertain. However imperfect, the endotype concept forces a focus on heterogeneity at a biological level, and the development of biomarkers of biological heterogeneity should help advance the goal of developing new therapies for COPD.<\/jats:p>","DOI":"10.1513\/annalsats.201808-533mg","type":"journal-article","created":{"date-parts":[[2018,12,14]],"date-time":"2018-12-14T10:35:23Z","timestamp":1544783723000},"page":"S234-S238","source":"Crossref","is-referenced-by-count":67,"title":["Targeting Chronic Obstructive Pulmonary Disease Phenotypes, Endotypes, and Biomarkers"],"prefix":"10.1093","volume":"15","author":[{"given":"Suresh","family":"Garudadri","sequence":"first","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prescott G.","family":"Woodruff","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, Sleep and Allergy, 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