THE COP:TRIN VISION
Chronic obstructive pulmonary disease (COPD) is a frequent condition worldwide that impairs breathing, causes coughing and mucus hypersecretion. In Denmark, the prevalence of COPD has been estimated at 430,000, of whom 40,000 have severe to very severe disease.
Our vision is to establish a nationwide respiratory medicine research collaboration consisting of highly skilled entities within biomarkers, genetics, epidemiology and clinical trials. The aim is to perform urgently needed pathophysiological, genetic, epidemiologic and clinical trials in an academic and independent research environment, building on strengths in Danish clinical research as well as biomarker technology.
Chronic obstructive pulmonary disease (COPD) is a frequent condition worldwide that impairs breathing, causes coughing and mucus hypersecretion. Acute Exacerbation of COPD (AECOPD), a condition often caused by lower airway infection, is characterized by hyper-inflammation in the lungs and increased symptoms leading to physical disability, anxiety, depression and premature death. Despite the high incidence of AECOPD worldwide and the devastating personal consequences, little is known about how—on an individual level—to reduce the frequency and severity of exacerbations and mortality rate in the subgroup of COPD patients who are “frequent exacerbators”. In this area there are several important unresolved issues:
Genetics and pathophysiology: Through state of the art genetic, pathophysiological and large scale epidemiological studies to increase the understanding of the diversity of disease processes taking place in different patients with AECOPD and thereby identifying specific patients in need of interventions targeted towards the specific pathophysiological processes taking place in an individual patient.
Evidence providing studies
Randomized controlled trials: On the basis of this knowledge (microbiomic profile, characterization of thrombosis risk, identification of patients at risk of persistent respiratory failure via biomarker studies) conduct randomized Good Clinical Practice controlled trials with interventions personalized to patients with specific pathophysiologic processes and only recruiting patients with a specific profile matching the pathophysiological and microbiomic profile, built on the knowledge reached in the studies on AECOPD. To intervene in a personalized manner, towards specific pathophysiological processes taking place in this certain patient.
No systematic, large scale approach to answer the above genetic, pathophysiological and clinical questions has so far been conducted. More knowledge of how to personalize therapy in this large patient group is urgently needed.
We will attempt to do this using our organization of
Copenhagen Unit for Respiratory Epidemiology (CURE)
Copenhagen Unit for Respiratory Epidemiology (CURE) will perform state-of-the-art epidemiological research based in Danish national health registers to answer current important questions regarding patients with chronic pulmonary diseases like chronic obstructive lung disease and interstitial lung diseases. Members of CURE are a mix of highly skilled researchers with a background in medical epidemiology and trials published in journals like The Lancet and other important medical journals, and junior investigators (typically PhD students) who coordinate and run one or more projects. The philosophy of the group is that epidemiology, basic research and randomized trials work well together to generate, explore and answer core scientific questions within respiratory medicine. All these key approaches will be used in the COPD Trial Initiative (COP:TRIN) and CURE is the epidemiological branch of the network.