Grazie per aver scelto di utilizzare a scopo didattico questo materiale

delle Guidelines 2011 libra.Le ricordiamo che questo materiale è di proprietà

dell’autore e fornito come supporto didattico per uso

personale.

Alvar Agustí

Systems medicine & COPD

Data-free lecture(almost)

Galas DJ, Hood L. IBC 1 (6):1-4, 2009

Systems medicine: basic hypothesis

• Diseases arises as a consequence of one or more biological networks in the relevant organ that have become disease-perturbed through genetic and/or environmental pathogenic changes.

Barabasi AL. N Engl J Med 357 (4):404-407, 2007

The human disease network

Goh et al. PNAS104 (21):8685-8690, 2007

The disease gene network

Goh et al. PNAS104 (21):8685-8690, 2007

Goh et al. PNAS104 (21):8685-8690, 2007

Goh et al. PNAS104 (21):8685-8690, 2007

Vestbo et al. ERJ 31 (4):869-873, 2008 Regan EA et al. COPD 7 (1):32-43, 2010

http://www.cancold.ca

http://www.cscc.unc.edu/spir/

Unbiased Biomarkersfor the Prediction

of Respiratory DiseaseOutcomes

Synergy

Airway Disease PRedicting Outcomes through Patient

Specific Computational Modelling

High throughput technology Bioinformatics

Genetic network GWAS

ncRNAmiDNA

miRNAEpigenetics

Innate inmunity

Ageing

Bioenergetics

Repair

Oxidative stressAcquired immunity

Biological network

Clinical phenotypesIntegrated carePersonalized medicine Guidelines network

Intermediate pathophenotypesDiagnostic biomarkersTherapeutic targets

Genetic markersRisk assessment

Life-styleModifiable factors

COPD

CVD

CancerMyopathty

OsteoporosisMetab Syn.

Clinical network

Environmental network

Pollution

Allergens

DietSmoking

Temperature

Infections

Agusti A , Vestbo J AJRCCM 2011

Systems medicine & COPD

N=30.000.000 individuos(Medicare)

Traditional medicine

Reactive = centered around diseases

P4 Medicine

P4= centered on health

Thanks for your attentionalvar.agusti@clinic.ub.es

International Centre forAdvanced Respiratory Medicine