COPD: It’s not only about smoking and old patients!
First international COPD-iNET Symposium redefines a global problem and an urgent need to decipher the disease’s multiple sub-types.
We urgently need more exchange about our findings from COPD research and clinical practice. But we need to broaden our perspective on the disease just as urgently: COPD is not just a disease of old, male smokers. Pollution, early-life infections, and even life-style choices have a tremendous impact on this complex disease, which seems to affect way more than the lungs.
That was essentially the conclusion of the two-day COPD-iNET symposium at the end of October in Hohenkammer near Munich. Initiated by a group of international COPD researchers led by the head of the Institute for Lung Health and Immunity (LHI, Helmholtz Munich), Prof. Ali Önder Yildirim, the symposium was a noticeably necessary premiere.
“COPD is an issue we must address globally! “, Yildirim began his greeting and probably none of the participants would have objected. Most speakers also agreed on another key challenge in the fight against this incurable disease: the causes and processes of how and why this disease develops and progresses have not yet been fully researched.
“Our view of COPD is too categorical; we underestimate the heterogeneity of this disease as well as the individual risk factors, some of which are already visible in premature babies,” warned Prof. Klaus F. Rabe in his keynote: “Precision Medicine in COPD: What's missing?“
In addition, the medical director of the Lung Clinic Großhansdorf and site director at the German Center for Lung Research (DZL) reported an exciting research result: Premature babies with poor lung function have an increased risk of developing COPD later in life. Early detection and prevention, especially concerning the inhalation of pollutants, are therefore important factors.
Rabe summarized the fact that COPD must be looked at systemically, for example in connection with cardiovascular diseases, osteoporosis, or depression, with the sentence: “Bad lung function is not good for your life! “. All these co-morbidities are very common in COPD patients and often manifest before the onset of the lung disease.
Rosa Faner (University of Barcelona) made clear that COPD needs a broader basis for research: “The traditional view of COPD as a self-inflicted disease caused by tobacco has been challenged by recent research findings. COPD can instead be understood as the potential end-result of the accumulation of gene–environment interactions encountered by an individual over the life course.”
Maor Sauler (Yale School of Medicine) added: “COPD is a complex disease. We need to identify the different phenotypes and endotypes and translate these findings into personalized therapies.”
Yohannes Tesfaigizi, Harvard Medical School Director, also formulated open questions for the research community: “Which cell triggers the development of COPD? Which genome variations (SNPs) play a role? We have to sort that out.”
Another view on future therapies came from Sir Peter Barnes, Imperial College London, the second key-note speaker of the Symposium. He showed the steps his lab is currently undertaking to develop novel therapeutic interventions: “This may treat COPD and its comorbidities as well as multimorbidity of the elderly, the most costly disease in the world.” He also underlined that life-style choices, like diet and exercise together with supportive senolytic (anti-aging) strategies represent important preventive interventions to decrease COPD incidence.
After two days of intensive discussions and excellent presentations by the international participants, the scientific coordinator of the COPD-iNET consortium, Roxana Wasnick, summarized the most important points:
- The community of COPD experts and their exchange must be expanded, including participants outside Europe and the USA.
- COPD needs to be seen and researched in a more systemic, complex way – identify early extra-pulmonary signs of the disease and delineate populations at risk.
- The risks for COPD are also more diverse: smoking remains the No. 1 factor, but air pollution, climate change and major fires also have to be taken into account.
Before the symposium is after the symposium, and all participants also agreed on this. After this successful premiere, the COPD-iNET consortium is planning the next meeting in 2024.
The network´s primary focus is the advancement of translational COPD research by discussing ongoing projects, cutting edge human in vitro/ex vivo models, state-of-the art systems biology approaches and clinical cohorts. We strive to identify and enable synergies to facilitate the discovery of novel COPD pathomechanisms. 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.
Members of the organizing committee are:
Prof. Dr. Ali Önder Yildirim, Dr. Thomas Conlon, Prof. Dr. Mareike Lehmann, Dr. Theodoros Kapellos, Dr. Roxana Wasnick – all Institute of Lung Health and Immunity (Helmholtz Munich) and DZL site Munich (CPC-M)
Prof. Dr. Reinoud Gosens, University of Groningen
Francesca Polverino, MD, Baylor College of Medicine, Houston
Maor Sauler, MD, Yale School of Medicine, US
Enid Rose Neptune, MD, Johns Hopkins Medicine