Table 1

List of potential treatable traits within the pulmonary domain to consider in patients with chronic airway disease

TraitTrait identification marker/diagnostic criteriaPossible treatmentsEvidence level I–IV#
Airway smooth muscle contractionBronchodilator reversibility, peak expiratory flow variability, airway hyperresponsivenessBronchodilators:
Maintenance: LABA/LAMA;
Rescue: SABA/SAMA/rapid-acting LABA
Systemic allergic inflammationElevated serum IgEAnti-IgE monoclonal antibody therapyI
DyspnoeaDyspnoea score ≥2, modified Medical Research Council scalePulmonary rehabilitation, breathing retrainingI
Emphysema (loss of elastic recoil)Chest CT, plethysmography, lung complianceSmoking cessation, lung volume reduction surgery, lung transplantation, α1-antitrypsin replacement if deficientI
Airway inflammation (eosinophilic)Sputum eosinophils ≥3% and/or FENO ≥30 ppb and/or blood eosinophils ≥0.3×109 cells·L−1Corticosteroids, anti-IL-5, -13, -4 monoclonal antibody therapyI-II
Pulmonary hypertensionDoppler echocardiography, brain natriuretic peptide, right heart catheterisationOxygen therapy, pulmonary vasodilator therapy, lung transplantationI-II
BronchiectasisHigh-resolution chest CTPhysiotherapy, mucociliary clearance techniques, macrolides, pulmonary rehabilitation, vaccinationI–II
Bacterial colonisationPresence of a recognised bacterial pathogen in sputum (sputum culture, quantitative PCR)Antibiotics and tailored antibiotic written action plan for infectionsII
Airway inflammation (neutrophilic)Sputum neutrophils ≥61%Macrolides, tetracyclines, roflumilastII
Cough reflex hypersensitivityCapsaicin challenge, cough counts, cough questionnaireSpeech pathology intervention, gabapentinII
Mucus hypersecretionVolume ≥25 mL of mucus produced daily for the past week in the absence of an infectionMucociliary clearance techniques with a physiotherapist, inhaled hypertonic saline, macrolidesII
HypoxaemiaPaO2 ≤55 mmHg; PaO2 56–59 mmHg and evidence of complications of hypoxaemia (e.g. pulmonary hypertension, polycythaemia, right-sided heart failure)Domiciliary oxygen therapyII

LABA: long-acting β2-agonists; LAMA: long-acting muscarinic antagonist; SABA: short-acting β2-agonists; SAMA: short-acting muscarinic antagonist; IgE: immunoglobulin E; CT: computed tomography; IL: interleukin; PaO2: partial pressure of oxygen. #: National Health and Medical Research Council (NHMRC) level of evidence currently available for the management/treatment of each trait; : studies examining the effectiveness of different treatments in bronchiectasis in general, not specifically in chronic airways disease patients with coexisting bronchiectasis. Content has been reproduced with permission from the Centre of Excellence in Treatable Traits, originally developed as part of the Centre of Excellence in Treatable Traits (