P4COPD: Prediction, Prevention, Personalized and Precision management of COPD in young adults
Background: Chronic Obstructive Pulmonary Disease (COPD) is a major health problem because of its high prevalence (10% in adults), increasing incidence (due to ageing of the population), associated morbidity and mortality (currently 3rd global cause of death) and associated social and economic cost. We have recently shown that COPD is not only a smoking related disease occurring in old individuals (the traditional paradigm), but the end result of dynamic and cumulative gene-environment interactions starting early in life. This opens new opportunities for the prediction, prevention, personalized and precise management (P4) of COPD in young adults. Objectives: (1) to investigate the genomic and environmental/lifestyle determinants of COPD in young adults (20-50 years); (2) to contrast them with those determined in children, adolescent and older individuals; and (3) to explore the feasibility and cost of implementing in clinical practice a P4 strategy for COPD in young adults. Methods: We will extend and update already existing cohorts (EarlyCOPD, INMA, Levante, UGR) of young subjects (20-50 years) in whom we will: (1) analyze demographic, epidemiological, clinical and physiologic information; (2) measure genetic, epigenetic and proteomic markers; (3) use advanced computer analytical methods to identify endotypes, biomarkers and potential therapeutic targets associated with the presence of COPD. These results in young individuals: (4) will be contrasted with general population (Pillar 1 IMPaCT, CADSET, HELIX, Episcan II) and COPD cohorts in older patients (Bode, Biomepoc, Chain, ECLIPSE). Besides, we will (5) explore how to implement this P4 medicine approach in clinical practice through the development of an individual COPD risk calculator, design and test educational activities, and (6) estimate its potential health cost implications.