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

[eng] 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 c...

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Detalles Bibliográficos
Autor: Noell, Guillaume
Tipo de recurso: tesis doctoral
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/145405
Acceso en línea:https://hdl.handle.net/2445/145405
http://hdl.handle.net/10803/667980
Access Level:acceso abierto
Palabra clave:Ciències de la salut
Malalties pulmonars obstructives cròniques
Medical sciences
Chronic obstructive pulmonary diseases
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spelling Multi-Level Integrated Analysis of Chronic Obstructive Pulmonary Disease (COPD) heterogeneityNoell, GuillaumeCiències de la salutMalalties pulmonars obstructives cròniquesMedical sciencesChronic obstructive pulmonary diseases[eng] 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.Universitat de BarcelonaAgustí García-Navarro, ÀlvarFaner, RosaUniversitat de Barcelona. Departament de Medicina2019info:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/145405http://hdl.handle.net/10803/667980Tesis Doctorals - Departament - Medicinareponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaIngléscc-by, (c) Noell,, 2019http://creativecommons.org/licenses/by/3.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1454052026-05-27T06:46:51Z
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
Malalties pulmonars obstructives cròniques
Medical sciences
Chronic obstructive pulmonary diseases
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
Malalties pulmonars obstructives cròniques
Medical sciences
Chronic obstructive pulmonary diseases
topic Ciències de la salut
Malalties pulmonars obstructives cròniques
Medical sciences
Chronic obstructive pulmonary diseases
description [eng] 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
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 https://hdl.handle.net/2445/145405
http://hdl.handle.net/10803/667980
url https://hdl.handle.net/2445/145405
http://hdl.handle.net/10803/667980
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv cc-by, (c) Noell,, 2019
http://creativecommons.org/licenses/by/3.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by, (c) Noell,, 2019
http://creativecommons.org/licenses/by/3.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 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 Tesis Doctorals - Departament - Medicina
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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