Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
Am J Respir Crit Care Med. 2011 May 1;183(9):1129-37. doi: 10.1164/rccm.201009-1414PP. Epub 2010 Dec 17.
Chronic obstructive pulmonary disease (COPD) is a complex disease at the clinical, cellular, and molecular levels. However, its diagnosis, assessment, and therapeutic management are based almost exclusively on the severity of airflow limitation. A better understanding of the multiple dimensions of COPD and its relationship to other diseases is very relevant and of high current interest. Recent theoretical (scale-free networks), technological (high-throughput technology, biocomputing), and analytical improvements (systems biology) provide tools capable of addressing the complexity of COPD. The information obtained from the integrated use of those techniques will be eventually incorporated into routine clinical practice. This review summarizes our current knowledge in this area and offers an insight into the elements needed to progress toward an integrated, multilevel view of COPD based on the novel scientific strategy of systems biology and its potential clinical derivative, P4 medicine (Personalized, Predictive, Preventive, and Participatory).
慢性阻塞性肺疾病（COPD）在临床、细胞和分子水平上都是一种复杂的疾病。然而，其诊断、评估和治疗管理几乎完全基于气流受限的严重程度。更好地了解 COPD 的多个方面及其与其他疾病的关系非常重要，也是当前的热点。最近的理论（无标度网络）、技术（高通量技术、生物计算）和分析方法（系统生物学）的改进为解决 COPD 的复杂性提供了工具。从这些技术的综合应用中获得的信息最终将被纳入常规临床实践。这篇综述总结了我们在这一领域的现有知识，并深入探讨了基于系统生物学这一新颖科学策略及其潜在的临床衍生方法 P4 医学（个体化、预测性、预防性和参与性）来实现 COPD 综合多层次观点所需的要素。
