Precision Medicine in Chronic Inflammation

Chronic inflammation can be defined as a sustained immunological reaction of the organism, where either the trigger is persistent or anti-inflammatory principles fail, thus leading to tissue remodeling and destruction via uncontrolled long-term activation of immune effector mechanisms. Chronic inflammation often affects barrier organs, which are continuously exposed to the environment. The cumulative lifetime prevalence of chronic inflammatory diseases in Northern Europe or in the US is well over 10%, with most of the disorders showing a surge in incidence over the last 5-10 decades. Most of the time, chronic inflammation is associated with metabolic, vascular, neurodegenerative, and malignant comorbidities. Thus, chronic inflammation has become a major medical burden. Despite all advances in medicine, the medical diagnosis of chronic inflammatory diseases is still based on macroscopic inspection of the inflammatory reaction of the affected organs and a collection of specific signs and symptoms. Understanding the actionable disease sub-phenotypes to predict progression and provide a rationale for individual therapeutic targets requires the integration of molecular information across multiple scales from pathways to cells and tissues and to the human organism as a whole. For chronic inflammatory diseases, we hypothesize that such a precise prediction of disease outcome will be possible if we are able to recognize and interpret immunological network perturbations, including those through therapy. It is important to state that results from such systems-oriented approaches will only be as precise as the clinical data underlying the hypothesis-generating algorithms. For these reasons, data integration requires structured metadata acquisition, regulated data warehousing of clinical as well as molecular data and integration of local biobanking into the health care of large, unselected (and therefore representative) patient cohorts.

Within the Research Topic, we summarize the hot topics in precision medicine which were presented at the International Symposium of the Cluster of Excellence “Precision Medicine in Chronic Inflammation”, held in Hamburg February 17th and 19th. The Research Topic is, however, also eager to stimulate the field beyond the topics held at the International Symposium, and thus looks forward to submissions fitting the overall scope of the Research Topic. Submissions dealing with chronic inflammatory diseases at barrier organs, such as the gut, lung, joints, heart and/or skin are especially welcome.