Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen Del Rocío/Universidad de Sevilla, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos III, Madrid, Spain.
COPD. 2019 Dec;16(5-6):311-320. doi: 10.1080/15412555.2019.1668919. Epub 2019 Oct 2.
With the 60th anniversary of the CIBA symposium, it is worth evaluating research questions that should be prioritized in the future. Coming research initiatives can be summarized in 10 main areas. (1) From epidemiology the impact of new forms of electronic cigarettes on prevalence and mortality of COPD will be sought. (2) The study of the disease endotypes and its relationship phenotypes will have to be unraveled in the next decade. (3) Diagnosis of COPD faces several challenges opening the possibility of a change in the definition of the disease itself. (4) Patients' classification and risk stratification will need to be clarified and reassessed. (5) The asthma-COPD overlap dilemma will have to be clarified and define whether both conditions represent one only chronic airway disease again. (6) Integrating comorbidities in COPD care will be key in a progressively ageing population to improve clinical care in a chronic care model. (7) Nonpharmacological management have areas for research including pulmonary rehabilitation and vaccines. (8) Improving physical activity should focus research because of the clear prognostic impact. (9). Pharmacological therapies present several challenges including efficacy and safety issues with current medications and the development of biological therapy. (10) The definition, identification, categorization and specific therapy of exacerbations will also be an area of research development. During the next decade, we have a window of opportunity to address these research questions that will put us on the path for precision medicine.
随着第 60 届 CIBA 研讨会的召开，值得评估未来应优先考虑的研究问题。即将开展的研究计划可以总结为 10 个主要领域。（1）从流行病学角度出发，研究新型电子烟对 COPD 患病率和死亡率的影响。（2）在未来十年内，必须阐明疾病内型及其与表型的关系。（3）COPD 的诊断面临着一些挑战，这可能会导致疾病定义本身发生变化。（4）需要阐明和重新评估患者的分类和风险分层。（5）哮喘-COPD 重叠难题需要澄清，并确定这两种情况是否再次代表一种慢性气道疾病。（6）在老龄化人口中，将共病纳入 COPD 治疗将是关键，以改善慢性病管理模式下的临床护理。（7）非药物治疗包括肺康复和疫苗等方面，有研究的空间。（8）由于预后有明显影响，提高身体活动应成为研究重点。（9）药物治疗存在一些挑战，包括现有药物的疗效和安全性问题，以及生物治疗的发展。（10）恶化的定义、识别、分类和特定治疗也将是研究发展的一个领域。在未来十年，我们有机会解决这些研究问题，这将使我们走上精准医学的道路。
