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Title: The EASI model: A first integrative computational approximation to the natural history of COPD
Author: Agustí García-Navarro, Àlvar
Compte, Albert
Faner, Rosa
García Aymerich, Judith
Noell, Guillaume
Cosío, Borja G.
Rodriguez-Roisin, Robert
Celli, Bartolome R.
Anto, Josep Maria
Keywords: Malalties pulmonars obstructives cròniques
Estadística mèdica
Chronic obstructive pulmonary diseases
Cigarette smokers
Medical statistics
Issue Date: 10-Oct-2017
Publisher: Public Library of Science
Abstract: The natural history of chronic obstructive pulmonary disease (COPD) is still not well understood. Traditionally believed to be a self-inflicted disease by smoking, now we know that not all smokers develop COPD, that other inhaled pollutants different from cigarette smoke can also cause it, and that abnormal lung development can also lead to COPD in adulthood. Likewise, the inflammatory response that characterizes COPD varies significantly between patients, and not all of them perceive symptoms (mostly breathlessness) similarly. To investigate the variability and determinants of different "individual natural histories" of COPD, we developed a theoretical, multi-stage, computational model of COPD (EASI) that integrates dynamically and represents graphically the relationships between exposure (E) to inhaled particles and gases (smoking), the biological activity (inflammatory response) of the disease (A), the severity (S) of airflow limitation (FEV1) and the impact (I) of the disease (breathlessness) in different clinical scenarios. EASI shows that the relationships between E, A, S and I vary markedly within individuals (through life) and between individuals (at the same age). It also helps to delineate some potentially relevant, but often overlooked concepts, such as disease progression, susceptibility to COPD and issues related to symptom perception. In conclusion, EASI is an initial conceptual model to interpret the longitudinal and cross-sectional relationships between E, A, S and I in different clinical scenarios. Currently, it does not have any direct clinical application, thus it requires experimental validation and further mathematical development. However, it has the potential to open novel research and teaching alternatives.
Note: Reproducció del document publicat a:
It is part of: PloS one, 2017, vol. 12, num. 10, p. e0185502
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (ISGlobal)

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