1. Grazie per aver scelto di utilizzare a scopo didattico questo materiale delle Guidelines 2011 libra. Le ricordiamo che questo materiale è di proprietà dellautore e fornito come supporto didattico per uso personale.

2. Alvar Agustí Systems medicine & COPD

3. Data-free lecture (almost)

4. Galas DJ, Hood L. IBC 1 (6):1-4, 2009 Systems medicine: basic hypothesis Diseases arises as a consequence of one or more biological networks in the relevant organ that have become disease-perturbed through genetic and/or environmental pathogenic changes.

6. Barabasi AL. N Engl J Med 357 (4):404-407, 2007

7. The human disease network Goh et al. PNAS104 (21):8685-8690, 2007

8. The disease gene network Goh et al. PNAS104 (21):8685-8690, 2007

12. Vestbo et al. ERJ 31 (4):869-873, 2008 Regan EA et al. COPD 7 (1):32-43, 2010 http://www.cancold.ca http://www.cscc.unc.edu/spir/

13. U nbiased Bio markers for the Pred iction of Respiratory Disease Outcomes Synergy Airway Disease PRedicting Outcomes through Patient Specific Computational Modelling

14. High throughput technology Bioinformatics

16. Genetic network GWAS ncRNA miDNA miRNA Epigenetics Innate inmunity Ageing Bioenergetics Repair Oxidative stress Acquired immunity Biological network Clinical phenotypes Integrated care Personalized medicine Guidelines network Intermediate pathophenotypes Diagnostic biomarkers Therapeutic targets Genetic markers Risk assessment Life-style Modifiable factors COPD CVD Cancer Myopathty Osteoporosis Metab Syn. Clinical network Environmental network Pollution Allergens Diet Smoking Temperature Infections Agusti A, Vestbo J AJRCCM 2011 Systems medicine & COPD

17. N=30.000.000 individuos (Medicare)

19. Traditional medicine Reactive = centered around diseases

20. P4 Medicine P4= centered on health

22. Thanks for your attention alvar.agusti@clinic.ub.es International Centre for Advanced Respiratory Medicine