Multi-Level Integrated Analysis of Chronic Obstructive Pulmonary Disease (COPD) heterogeneity

Non-Communicable Diseases (NCDs), including cancer, cardiovascular (heart diseases or stroke), respiratory (COPD or asthma) and metabolic diseases (diabetes) are chronic conditions that represent a major global health problem of the 21st century. All of them, however, are the end-result of a complex...

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Autor: Noell, Guillaume
Tipo de recurso: tesis doctoral
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:CBUC, CESCA
Repositorio:TDR. Tesis Doctorales en Red
OAI Identifier:oai:www.tdx.cat:10803/667980
Acceso en línea:http://hdl.handle.net/10803/667980
Access Level:acceso abierto
Palabra clave:Ciències de la salut
Ciencias biomédicas
Medical sciences
Malalties pulmonars obstructives cròniques
Enfermedad pulmonar obstructiva crónica
Chronic obstructive pulmonary diseases
Ciències de la Salut
577
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oai_identifier_str oai:www.tdx.cat:10803/667980
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spelling Multi-Level Integrated Analysis of Chronic Obstructive Pulmonary Disease (COPD) heterogeneityNoell, GuillaumeCiències de la salutCiencias biomédicasMedical sciencesMalalties pulmonars obstructives cròniquesEnfermedad pulmonar obstructiva crónicaChronic obstructive pulmonary diseasesCiències de la Salut577Non-Communicable Diseases (NCDs), including cancer, cardiovascular (heart diseases or stroke), respiratory (COPD or asthma) and metabolic diseases (diabetes) are chronic conditions that represent a major global health problem of the 21st century. All of them, however, are the end-result of a complex set of gene-environment interactions that develop over years and often lead to several NCDs co-existing in the same individual (multi-morbidity). Multi-level integrated analysis has the potential to uncover the heterogeneity of NCDs by conceptualizing them as emergent properties of a complex, non-linear, dynamic and multilevel biological system, or network of biological and environmental interactions. Chronic Obstructive Pulmonary Disease (COPD) is a NCD of increasing prevalence worldwide that is projected to be by 2020 the third leading cause of death worldwide. It is currently viewed as a broad diagnostic term that encompass a continuum of subtypes each characterized by distinct functional or pathobiological mechanisms (endotypes) and is characterized by persistent respiratory symptoms and airflow limitation. The underlying hypothesis of this PhD Thesis is that multi-level integrated analysis can help us understand highly heterogeneous respiratory diseases such as COPD. Specifically, the following two aspects of COPD heterogeneity will be addressed: 1) Exacerbations of COPD (ECOPD): ECOPD are episodes of worsening of the symptoms whose pathogenesis and biology are not entirely understood. They are heterogeneous events of non-specific diagnosis. Biomarkers analysis and networks medicine were used to uncover novel pathobiological information from the comparison of the multi-level (i.e., clinical, physiological, biological, imaging and microbiological) correlation networks determined during ECOPD and clinical recover. We concluded that ECOPD are characterised by disruption of network homeokinesis that exists during convalescence and can be identified objectively by using a panel of three biomarkers (dyspnoea, circulating neutrophils and CRP levels) frequently determined in clinical practice. 2) Early low lung function and health in later life: In 2015 Lange P. et al. showed that low peak lung function in early adulthood is associated with the diagnosis of COPD later in life. We assessed in three general population cohorts the prevalence of low peak lung function and its association with other clinical or biological parameters - specifically respiratory, cardiovascular, and metabolic abnormalities – as well as incidence of comorbid diseases during follow-up. We concluded that low peak lung function in early adulthood is common in the general population and could identify a group of individuals at risk of early (cardiovascular, metabolic and systemic) comorbidities and premature death.Universitat de BarcelonaAgustí García-Navarro, ÀlvarFaner, RosaUniversitat de Barcelona. Departament de Medicina201920192019info:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/publishedVersion95 p.application/pdfapplication/pdfhttp://hdl.handle.net/10803/667980TDX (Tesis Doctorals en Xarxa)reponame:TDR. Tesis Doctorales en Redinstname:CBUC, CESCAInglésL'accés als continguts d'aquesta tesi queda condicionat a l'acceptació de les condicions d'ús establertes per la següent llicència Creative Commons: http://creativecommons.org/licenses/by/4.0/http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:www.tdx.cat:10803/6679802026-06-14T12:46:07Z
dc.title.none.fl_str_mv Multi-Level Integrated Analysis of Chronic Obstructive Pulmonary Disease (COPD) heterogeneity
title Multi-Level Integrated Analysis of Chronic Obstructive Pulmonary Disease (COPD) heterogeneity
spellingShingle Multi-Level Integrated Analysis of Chronic Obstructive Pulmonary Disease (COPD) heterogeneity
Noell, Guillaume
Ciències de la salut
Ciencias biomédicas
Medical sciences
Malalties pulmonars obstructives cròniques
Enfermedad pulmonar obstructiva crónica
Chronic obstructive pulmonary diseases
Ciències de la Salut
577
title_short Multi-Level Integrated Analysis of Chronic Obstructive Pulmonary Disease (COPD) heterogeneity
title_full Multi-Level Integrated Analysis of Chronic Obstructive Pulmonary Disease (COPD) heterogeneity
title_fullStr Multi-Level Integrated Analysis of Chronic Obstructive Pulmonary Disease (COPD) heterogeneity
title_full_unstemmed Multi-Level Integrated Analysis of Chronic Obstructive Pulmonary Disease (COPD) heterogeneity
title_sort Multi-Level Integrated Analysis of Chronic Obstructive Pulmonary Disease (COPD) heterogeneity
dc.creator.none.fl_str_mv Noell, Guillaume
author Noell, Guillaume
author_facet Noell, Guillaume
author_role author
dc.contributor.none.fl_str_mv Agustí García-Navarro, Àlvar
Faner, Rosa
Universitat de Barcelona. Departament de Medicina
dc.subject.none.fl_str_mv Ciències de la salut
Ciencias biomédicas
Medical sciences
Malalties pulmonars obstructives cròniques
Enfermedad pulmonar obstructiva crónica
Chronic obstructive pulmonary diseases
Ciències de la Salut
577
topic Ciències de la salut
Ciencias biomédicas
Medical sciences
Malalties pulmonars obstructives cròniques
Enfermedad pulmonar obstructiva crónica
Chronic obstructive pulmonary diseases
Ciències de la Salut
577
description Non-Communicable Diseases (NCDs), including cancer, cardiovascular (heart diseases or stroke), respiratory (COPD or asthma) and metabolic diseases (diabetes) are chronic conditions that represent a major global health problem of the 21st century. All of them, however, are the end-result of a complex set of gene-environment interactions that develop over years and often lead to several NCDs co-existing in the same individual (multi-morbidity). Multi-level integrated analysis has the potential to uncover the heterogeneity of NCDs by conceptualizing them as emergent properties of a complex, non-linear, dynamic and multilevel biological system, or network of biological and environmental interactions. Chronic Obstructive Pulmonary Disease (COPD) is a NCD of increasing prevalence worldwide that is projected to be by 2020 the third leading cause of death worldwide. It is currently viewed as a broad diagnostic term that encompass a continuum of subtypes each characterized by distinct functional or pathobiological mechanisms (endotypes) and is characterized by persistent respiratory symptoms and airflow limitation. The underlying hypothesis of this PhD Thesis is that multi-level integrated analysis can help us understand highly heterogeneous respiratory diseases such as COPD. Specifically, the following two aspects of COPD heterogeneity will be addressed: 1) Exacerbations of COPD (ECOPD): ECOPD are episodes of worsening of the symptoms whose pathogenesis and biology are not entirely understood. They are heterogeneous events of non-specific diagnosis. Biomarkers analysis and networks medicine were used to uncover novel pathobiological information from the comparison of the multi-level (i.e., clinical, physiological, biological, imaging and microbiological) correlation networks determined during ECOPD and clinical recover. We concluded that ECOPD are characterised by disruption of network homeokinesis that exists during convalescence and can be identified objectively by using a panel of three biomarkers (dyspnoea, circulating neutrophils and CRP levels) frequently determined in clinical practice. 2) Early low lung function and health in later life: In 2015 Lange P. et al. showed that low peak lung function in early adulthood is associated with the diagnosis of COPD later in life. We assessed in three general population cohorts the prevalence of low peak lung function and its association with other clinical or biological parameters - specifically respiratory, cardiovascular, and metabolic abnormalities – as well as incidence of comorbid diseases during follow-up. We concluded that low peak lung function in early adulthood is common in the general population and could identify a group of individuals at risk of early (cardiovascular, metabolic and systemic) comorbidities and premature death.
publishDate 2019
dc.date.none.fl_str_mv 2019
2019
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/doctoralThesis
info:eu-repo/semantics/publishedVersion
format doctoralThesis
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10803/667980
url http://hdl.handle.net/10803/667980
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 95 p.
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Universitat de Barcelona
publisher.none.fl_str_mv Universitat de Barcelona
dc.source.none.fl_str_mv TDX (Tesis Doctorals en Xarxa)
reponame:TDR. Tesis Doctorales en Red
instname:CBUC, CESCA
instname_str CBUC, CESCA
reponame_str TDR. Tesis Doctorales en Red
collection TDR. Tesis Doctorales en Red
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.300724

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