Endotype

An endotype is a subtype of a condition, which is defined by a distinct functional or pathobiological mechanism. This is distinct from a phenotype, which is any observable characteristic or trait of a disease, such as morphology, development, biochemical or physiological properties, or behavior, without any implication of a mechanism. It is envisaged that patients with a specific endotype present themselves within phenotypic clusters of diseases.

One example is asthma, which is considered to be a syndrome, consisting of a series of endotypes.[1] This is related to the concept of disease entity

Disease entity

The main concept in nosology is the disease entity. Normally there are two ways to define a disease entity: Manifestational criteria and Causal criteria.[2]

Following Fred Gifford,[3] these criterias lead to view any disease entity in three different forms:[4]

Following again F. Gifford, in fact each of the previous definitions can include the etiology or can be etiology agnostic. Other authors simply continue with the classification previous Whitbeck, leaving just three kind of definitions (clinical, pathological and etiological)[5]

It is important to remark that a real world definition is normally an hybrid between these previous kinds, and an endotype should use all three of descriptors, including etiology, to guarantee specificity.

See also

Notes

  1. Lötvall J, Akdis CA, Bacharier LB, Bjermer L, Casale TB, Custovic A, Lemanske RF Jr, Wardlaw AJ, Wenzel SE, Greenberger PA. Asthma endotypes: A new approach to classification of disease entities within the asthma syndrome. J Allergy Clin Immunol. 2011 Feb;127(2):355-60.
  2. Victor J. Schoenbach, Phenomenon of disease, 2000
  3. Peter Hucklenbroich, Disease Entity” as the Key Theoretical Concept of Medicine, Journal of Medicine and Philosophy, Volume 39, Issue 6, Pp. 609-633.
  4. Fred Gifford (2011). Philosophy of Medicine. Elsevier.
  5. Caroline Whitbeck, Causation in medicine: The disease entity model, Philosophy of science 44, 1977

References


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