Day 1 :
Keynote Forum
Joaquim Gea
Dean of the School of Medicine
Universitat Pompeu Fabra
Barcelona
Spain
Keynote: Low Physical Activity and COPD: Prognosis and handling of this clinical problem
Time : 09:55-10:35
Biography:
Joaquim Gea obtained his MD (1979) and PhD (1989) degrees at the Universitat de Barcelona, being specialist in both Internal Medicine (1981) and Respiratory Medicine (1985). He is the Head of the Respiratory Department at Hospital del Mar, Full Professor and Dean in the School of Medicine at Universitat Pompeu Fabra and has been Visiting professor at McGill (94-95) and Johns Hopkins (2010-11) universities, and Deputy Director of the Spanish Network of Excellence for Research in Respiratory Diseases (CIBERES). He has been funded by 65 competitive grants, including 4 projects from the European Commission, and published more than 260 Original Articles and Reviews in peer reviewed journals as well as 50 book chapters.
Abstract:
Chronic obstructive pulmonary disease (COPD) is considered a multidimensional disorder since, in addition to the lung disease, it also has important systemic manifestations and is associated with significant comorbidities. Respiratory and anxious-depressive symptoms, together with the Western lifestyle, often lead to a progressive limitation in the level of physical activity. This leads to higher levels of depression as well as to cardiovascular and skeletal muscle deconditioning along with alterations in bone metabolism and quality. All these changes increase the negative impact on the level of physical activity, which continues its decline, generating a progressive vicious circle, with important consequences in different clinical outcomes: development of or increased severity in different comorbidities, more hospitalizations and increased mortality. Therefore, it is necessary to improve the clinical management of COPD patients by early detecting inappropriate low levels of activity and optimizing the treatment. The latter should necessarily include the treatment of both respiratory and psychological symptoms, while attempting to directly incentivate the increase in the level of activity. Thus, the strategy must include bronchodilators (long-acting beta-agonists and anticholinergic drugs), pulmonary rehabilitation (mainly general training) and behavioral changes. To determine and monitor the level of physical activity is also an important point of the management. For this purpose, different instruments have been developed and are now available, including actigraphs, pedometers and questionnaires. Conclusion: Physical activity is a key element in COPD prognosis, and therefore low levels of daily activity must be detected, monitored and properly treated.
Keynote Forum
Patrick Vanscheeuwijck
Director pre-clinical toxicology at Philip Morris International, Reduced Risk Products, and Switzerland
Keynote: Physiological Measures and Novel Sputum Biomarkers to Distinguish Subjects with Mild to Moderate COPD from Asymptomatic Current Smokers, Former Smokers and Never-Smokers
Time : 10:55-11:35
Biography:
Dr. Patrick Vanscheeuwijck is Director pre-clinical toxicology at Philip Morris International, Reduced Risk Products, and Switzerland, responsible for the in vitro and in vivo assessment of Reduced Risk Products (RRPs). The focus of his career at PMI has been on the development of approaches for the assessment of hazard associated with cigarette smoke and aerosols from RRPs, inhalation toxicology and animal models of disease; with more than 30 peer-reviewed publications. He has a Ph.D. in biochemical pharmacology (University of Gent, Belgium), performed postdocs at the University of Arizona, U.S. and the University of Leuven, Belgium in molecular pharmacology and molecular biology
Abstract:
Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by progressive airflow limitation, with globally increasing prevalence. Although efforts to simplify COPD diagnosis to a single repeatable test using spirometry has proved critical in the day-to-day diagnosis and management of the disease, it is clear that COPD is a complex disease whose phenotypes may not be adequately captured by spirometry alone. Moreover, suitable biomarkers for the diagnosis, treatment and prognosis are still lacking. Therefore, we conducted a case-control study designed to identify a biomarker (panel) for the differentiation of subjects with mild and moderate COPD, asymptomatic current, former and never-smokers and to compare physiological measurements and quality of life (QoL) across the study groups (NCT01780298). Our data shows that there are a number of subjects that would be diagnosed as healthy using spirometry alone. However, these data also suggest that complementary tests such as CT chest imaging or lung sound analysis may prove helpful in identifying asymptomatic smokers at risk or with subclinical disease. Potential biomarkers identified by ‘omics’ analyses may support this stratification further. For example, sputum analysis detected cigarette smoking-related alterations in the transcriptome and proteome, which were further augmented in COPD smokers. Strikingly, proteomics data could distinguish COPD from asymptomatic smokers with a similar accuracy as the combination of three commonly used physiological parameters, FEV1, TLCO % and total COPD score.
Keynote Forum
Patrick Vanscheeuwijck
Director
Philip Morris International
Switzerland
Keynote: Physiological Measures and Novel Sputum Biomarkers to Distinguish Subjects with Mild to Moderate COPD from Asymptomatic Current Smokers, Former Smokers and Never-Smokers
Time : 10:55-11:35
Biography:
Dr. Patrick Vanscheeuwijck is Director pre-clinical toxicology at Philip Morris International, Reduced Risk Products, and Switzerland, responsible for the in vitro and in vivo assessment of Reduced Risk Products (RRPs). The focus of his career at PMI has been on the development of approaches for the assessment of hazard associated with cigarette smoke and aerosols from RRPs, inhalation toxicology and animal models of disease; with more than 30 peer-reviewed publications. He has a Ph.D. in biochemical pharmacology (University of Gent, Belgium), performed postdocs at the University of Arizona, U.S. and the University of Leuven, Belgium in molecular pharmacology and molecular biology.rnrn
Abstract:
Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by progressive airflow limitation, with globally increasing prevalence. Although efforts to simplify COPD diagnosis to a single repeatable test using spirometry has proved critical in the day-to-day diagnosis and management of the disease, it is clear that COPD is a complex disease whose phenotypes may not be adequately captured by spirometry alone. Moreover, suitable biomarkers for the diagnosis, treatment and prognosis are still lacking. Therefore, we conducted a case-control study designed to identify a biomarker (panel) for the differentiation of subjects with mild and moderate COPD, asymptomatic current, former and never-smokers and to compare physiological measurements and quality of life (QoL) across the study groups (NCT01780298). Our data shows that there are a number of subjects that would be diagnosed as healthy using spirometry alone. However, these data also suggest that complementary tests such as CT chest imaging or lung sound analysis may prove helpful in identifying asymptomatic smokers at risk or with subclinical disease. Potential biomarkers identified by ‘omics’ analyses may support this stratification further. For example, sputum analysis detected cigarette smoking-related alterations in the transcriptome and proteome, which were further augmented in COPD smokers. Strikingly, proteomics data could distinguish COPD from asymptomatic smokers with a similar accuracy as the combination of three commonly used physiological parameters, FEV1, TLCO % and total COPD score
Keynote Forum
Joaquim Gea
Dean of the School of Medicine
Universitat Pompeu Fabra
Barcelona
Spain
Keynote: Low Physical Activity and COPD: Prognosis and handling of this clinical problem
Time : 09:55-10:35
Biography:
Joaquim Gea obtained his MD (1979) and PhD (1989) degrees at the Universitat de Barcelona, being specialist in both Internal Medicine (1981) and Respiratory Medicine (1985). He is the Head of the Respiratory Department at Hospital del Mar, Full Professor and Dean in the School of Medicine at Universitat Pompeu Fabra and has been Visiting professor at McGill (94-95) and Johns Hopkins (2010-11) universities, and Deputy Director of the Spanish Network of Excellence for Research in Respiratory Diseases (CIBERES). He has been funded by 65 competitive grants, including 4 projects from the European Commission, and published more than 260 Original Articles and Reviews in peer reviewed journals as well as 50 book chapters.
Abstract:
Chronic obstructive pulmonary disease (COPD) is considered a multidimensional disorder since, in addition to the lung disease, it also has important systemic manifestations and is associated with significant comorbidities. Respiratory and anxious-depressive symptoms, together with the Western lifestyle, often lead to a progressive limitation in the level of physical activity. This leads to higher levels of depression as well as to cardiovascular and skeletal muscle deconditioning along with alterations in bone metabolism and quality. All these changes increase the negative impact on the level of physical activity, which continues its decline, generating a progressive vicious circle, with important consequences in different clinical outcomes: development of or increased severity in different comorbidities, more hospitalizations and increased mortality. Therefore, it is necessary to improve the clinical management of COPD patients by early detecting inappropriate low levels of activity and optimizing the treatment. The latter should necessarily include the treatment of both respiratory and psychological symptoms, while attempting to directly incentivate the increase in the level of activity. Thus, the strategy must include bronchodilators (long-acting beta-agonists and anticholinergic drugs), pulmonary rehabilitation (mainly general training) and behavioral changes. To determine and monitor the level of physical activity is also an important point of the management. For this purpose, different instruments have been developed and are now available, including actigraphs, pedometers and questionnaires. Conclusion: Physical activity is a key element in COPD prognosis, and therefore low levels of daily activity must be detected, monitored and properly treated.