Objectives

The seminar aims to bring together experts from different disciplines (clinicians, epidemiologists, biologists, pharmacologists, pathologists), both members and non-members of the Advanced COPD Research Network to:

• Identify knowledge gaps in COPD research approached from a multidisciplinary perspective, focusing on regeneration.
• Define novel key questions on translational COPD research focusing on early disease pathogenesis and disease phenotypes/endotypes to enable regeneration.
• Strengthen and expand the existing COPD Research Network among leading global experts and early-career rising stars to support researchers at many levels.

Outcomes

• A state-of-the-art review article in the European Respiratory Journal, written by a group of early-career researchers attending the seminar under the guidance of experienced COPD researchers.
• A second educational-focused review for publication in Breathe with a focus on residents in respiratory medicine written by clinical early-career researcher members, with the support of experienced researchers.
• A follow-up webinar on the ERS Respiratory Channel, organised by the research seminar chairs.
• The expansion of the Advanced COPD Research Network.

Overview

COPD is a progressive pulmonary disorder, especially amongst the elderly, presenting with largely irreversible airflow limitation, a result of chronic bronchitis and/or irreversible damage of the lung tissue (emphysema).

COPD is the third-leading cause of death worldwide, affecting more than 400-600 million people globally. It kills over three million people per year, with no curative therapy currently available.

The staggering socio-economic burden that comes with COPD treatment is also now surpassing any other disease. Among 23 EU member states, the average prevalence is 15-20%, which increases with age. COPD is a heterogeneous disease encompassing multiple organs beyond the lungs. Both pulmonary and extrapulmonary pathology cause a high clinical and societal burden.

COPD has long been considered a disease of smoking, but only a fraction of exposed individuals develop the disease, and 25-40% of COPD patients have never smoked. Ample evidence suggests vulnerability for COPD development stems from (epi)genetic risk factors and interaction with environmental exposure across the life course, as early as in childhood, aging of the global population, and poor dietary quality intake combined with sedentary behaviour. A major hurdle remains the identification of different disease endotypes, early detection and cellular and molecular mechanisms of early disease development. Despite the heterogeneity of the disease, diagnostic approaches have not markedly changed in decades and patients are not stratified according to condition, explaining therapy and clinical trial failure. To change this, we need a better understanding of pathophysiological mechanisms.

Here, a major chance lies in the international collaboration of basic, translational and clinical researchers, which is so far not well organised. To change this, a group of researchers, including the two seminar chairs and spearheaded by Önder Yildirim, have recently established an international Advanced COPD Research Network.

The network´s primary focus is the advancement of translational COPD research by discussing ongoing projects, cutting-edge human in vitro models, state-of-the art systems biology approaches and clinical cohorts. By fostering new collaborations and ideas to transform our understanding of COPD, we aim to ignite novel research directions and therapeutic avenues thereby paving the way to eliminate COPD.

The network identified key areas for future COPD research that align with current priority topics of Assembly 3 (‘Cellular plasticity in lung regeneration’, ‘cell-cell interactions in lung physiology and disease’, ‘immune metabolic changes in lung disease’, ‘state-of-the-art models to answer clinical questions’); Assembly 5 (priority topics: ‘No cell is an island – clinical implications of immunological crosstalk in the lung’); Assembly 7 (priority topics: ‘Prematurity related lung diseases’); Assembly 1 (Priority topics: ‘Functional lung imaging); and Assembly 14 (Priority topics: ‘Advances in thoracic imaging’).

The four key ares of the network are:

• Endotyping of COPD cohorts
• Systems biology
• Immunity
• Repair and regeneration

The network aims at a) exchanging scientific knowledge, b) sharing models and resources c) connecting the right people to facilitate joined research projects and grant proposals. The network identified key areas for future COPD research: 1. COPD cohorts, 2. Systems biology, 3. Immunity, and 4. Repair and regeneration.

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May, S.M., and Li, J.T. (2015). Burden of chronic obstructive pulmonary disease: healthcare costs and beyond. Allergy and asthma proceedings 36, 4-10. 10.2500/aap.2015.36.3812.

Stolz, D., Mkorombindo, T., Schumann, D.M., Agusti, A., Ash, S.Y., Bafadhel, M., Bai, C., Chalmers, J.D., Criner, G.J., Dharmage, S.C., et al. (2022). Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission. Lancet 400, 921-972. 10.1016/S0140-6736(22)01273-9.

Vogelmeier, C.F., Criner, G.J., Martinez, F.J., Anzueto, A., Barnes, P.J., Bourbeau, J., Celli, B.R., Chen, R., Decramer, M., Fabbri, L.M., et al. (2017). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary. American journal of respiratory and critical care medicine 195, 557-582. 10.1164/rccm.201701-0218PP. [/read]