Page 28 - MEMOCiberes014-ENG

and frequent exacerbations . The more fragile patients will show the most prominent markers of COPD activity that can be later applied to a cohort of early COPD patients in order to predict the type of progression . Markers of activity can be identified in the clinical, biopathology, microbiology and imaging domains .
Aims and objectives
The main aim of this project is to demonstrate and define properly the concept of biologic activity in COPD as the undergoing mechanism that leads to differential evolution of disease, ranging from the low activity with low impact and low progression of disease to the high activity with high impact and rapid progression . As starting point, it is assumed that the fragile patients with more severe disease are those in which the disease is-or has been-more active . For that reason, this project plans to explore the concept of activity in a fragile COPD population from the clinical, microbiologic and experimental point of view as a first step, and subsequently apply the information obtained from them into a population at early stages of disease . Mechanistic studies in animal models of fragile, early COPD and microbial infection will help to probe the hypothesis generated from the clinical studies . To achieve this general goal, the following specific objectives will be pursued:
1- To validate frailty criteria in relation to prognosis and evaluate the impact of different Health Care approaches to management on disease activity by generating a fragile COPD cohort .
2- To analyse clinical, imaging and biological markers of activity as determinants of disease progression and severity in fragile COPD patients .
3- To identify microbiology patterns or changes within the pathogen or the host associated to disease progression in Fragile COPD patients .
4- To investigate potential markers of activity in animal models .
5- To integrate the previously identified markers of activity in fragile patients into a cohort of early COPD patients in order to identify the patients with more active disease and faster progression .
Main results until the end of 2014
Participation in the writing and editing of the review entitled “Global initiative for chronic obstructive lung disease . Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease” . It is the most important world reference for the clinical management of COPD . Accessible at the following address: www .goldcopd .org .
CLINICAL GUIDELINES AND RECOMMENDATIONS:
• Ram FS, Rodríguez-Roisin R, Granados-Navarrete A, García- Aymerich J, Barnes NC . WITHDRAWN: Antibioticsforexacerbations of chronic obstructive pulmonary disease . Documento publicado en la Cochrane Database Syst Rev . 2011; 1: CD004403 .
• Luján M, Sogo A, Monsó E . Home Mechanical Ventilation - Monitoring Software: Measure More or Measure Better? Arch Bronconeumol . 2011 Dec 27 . [Epub ahead of print]
• Informe: - AUDIPOC: Auditoría Clínica Nacional sobre - exacerbaciones de la EPOC en España . Proyecto coordinado . Subproyecto AUDIPOC Cataluña . E . Monso, Martínez-Rivera, C, Pozo P, Álvarez, C; Capelastegui, A; Hernández, C; Izquierdo, Jk . Haro, M, Antón, PA; Hernández, C; Rodríguez,E; Lloret, JA; Rodríguez, N; Rozadilla, J .
28
CIBERES » Annual report 2014