School of European Respiratory Society in Italy: Monitoring of Airway Diseases

I would like to share with you my experience and impressions about the School of European Respiratory Society in Italy: Monitoring of Airway Diseases, which took place in Veruno, Italy at 24 – 26 March 2011.

The main topic of the School was the very actual problem of the clinical respiratory medicine - Monitoring of Airway diseases. Under the guidance of a international faculty who are experts in their field all participants were provided with a critical overview of different modes of monitoring airway diseases and associated inflammation and oxidative stress in research and clinical practice.

The pathophysiological role of inflammation in lung diseases including asthma and chronic obstructive pulmonary disease is well established. Quantifying lung inflammation is relevant for the management of inflammatory airway diseases as it may indicate that pharmacological intervention is required before symptom onset and reduction in lung function. Moreover, monitoring of airway inflammation might be useful in the follow-up of patients with asthma and COPD, and for guiding pharmacological therapy. Quantification of pulmonary inflammation is currently based more on invasive methods including the analysis of broncho-alveolar lavage fluid, bronchoscopy, and bronchial biopsies, semi-invasive methods such as sputum induction, and the measurement of inflammatory biomarkers in plasma and urine, which are likely to reflect systemic rather than lung inflammation. Interest in the identification of non-invasive biomarkers for inflammatory airway diseases has been growing. Along these years less invasive methodologies have been introduced, such as induced sputum and the evaluation of various markers in exhaled air (NO, exhaled breath condensate, etc).

School of European Respiratory Society in Italy was organized by 3 well-known leaders of opinion in the field of biomarkers in respiratory diseases:

·        Elisabeth Bel (Amsterdam, the Netherlands),

·        Ildiko Horvath (Budapest, Hungary)

·        and the host of the event Bruno Balbi (Veruno, Italy).

At the 1^st Day of the School there were 2 sessions:

Session I – Current applications of traditional tests of disease monitoring

Session II – Information gained from induced sputum

Professor Bruno Balbi talked about Limitations of traditional tests, unanswered aspects of airway diseases.

Chair of ERS 2011 Amsterdam Congress, Elisabeth Bel presented Measurement of airway hyperresponsiveness. Co-chair of ERS 2011 Amsterdam Congress, professor Peter J. Sterk (Netherlands) made presentation about Applications of induced sputum sampling in asthma and Value of exhaled volatile organic compounds in monitoring airway disease.

2^nd Day of the School: Session III New categories of patients, new methodologies.

I want to mention highly informative parallel sessions “How to do it” hands-on training: Airway hyperresponsiveness assessment, Sputum induction, Exhaled markers measurement and Exhaled breath condensate collection.

3rd Day of the School was dedicated to Session IV – Exhaled breath biomarkers.

2 Brilliant, exciting talks by Piter Barnes, Professor of Thoracic Medicine and Head of Airway Disease at the National Heart and Lung Institute and Honorary Consultant Physician at Royal Brompton Hospital, London were dedicated to Applications of exhaled and nasal NO in airway diseases and Markers of airway diseases in exhaled breath condensate.

As participants during and after course we:

• Recognize common and unusual findings in different methods used for monitoring of airway diseases both in adults and children.
• Correlate clinical presentation with results of traditional and newly developed methods of monitoring (i.e. lung function tests, exhaled breath measurements, induced sputum results).
• Better understand the relationship between the results of lung function tests, markers of airway inflammation/oxidative stress and severity of asthma and COPD.
• Gain knowledge on the diagnostic value and utility in diseases of the different monitoring techniques.
• Learn about the newest developments in the field of non-invasive assessment of airway inflammation and its potential effect on therapy.

The School of European Respiratory Society: Monitoring of Airway Diseases was a well attended meeting with participation of more than 50 pneumologists, pneumology trainees and research fellows from Sweden, Belgium, Israel, Norway, Moldova, Netherlands, Serbia, Bulgaria, Switzerland, Spain, Portugal, Italy, New Zeeland, Philippines, Latvia, Turkey, Albania, etc.

ERS Projects Coordinator Alexandre Delage and ERS Events assistant Laura Montangero provided good quality of organization of event and high education level corresponding to the standards of European Respiratory Society.

All presentations from this ERS School will be uploaded and available in a short time.

I would like to thank and congratulate European Respiratory Society and Organizing Committee for a successful School which allowed to taking part in different discussions and workshops, acquiring useful information and establishing relations with international specialists in the field.

Lake Maggiore

World Respiratory Changing video - Respiratory Decade: key words and principles

We are really proud and happy to present you World Respiratory Changing video by our Communication Manager Mila Corlateanu dedicated to key words and principles of Respiratory Decade!

The European COPD Audit

Chronic Obstructive Pulmonary Disease (COPD) is a significant cause of morbidity and mortality in Europe and a major drain on resources in both primary and secondary healthcare. COPD has an increasingly high profile with health authorities, health insurance companies and healthcare providers in Europe.

Evidence is growing that COPD patient care varies widely between different hospitals and between different European countries, and is frequently not consistent with published guidelines. There are many different service models and it remains unknown which deliver the best results for patients. In all likelihood, we can all improve the care we give to COPD patients if we have better knowledge of our own performance regarding to patient care and a greater understanding of the service organisational factors in European hospitals that promote better outcomes.

Data-collection

As of October 2010, sixteen countries take part in the seven months data-collection phase of the first audit of COPD care across Europe. This audit involves collecting data about the way hospitals in different European countries provide care for COPD patients as well as clinical data on the process of care and outcomes for COPD patients admitted to a hospital with an exacerbation. The data-collection will be carried out using a web-based survey tool with the aim of publishing reports and analyses by mid 2011. 

If successful, we hope this COPD audit will serve as a basis for EU-funded audits in the whole of Europe and beyond.

 Positive Outcomes

The anticipated outcome of this COPD audit is to raise the standards of COPD care for patients to a level consistent with European management guidelines.

The COPD audit process will collect clinical data from COPD patients and information about the organisation and services within individual hospitals of each participating European country. The clinical outcomes and organisational data will be compared with those of other hospitals in the same country and elsewhere in Europe.

The results of this COPD audit will provide invaluable information on the strengths and weaknesses of COPD patient care. Innovative services and associations between service models and outcomes within European hospitals will be identified. This information can be shared between participating European hospitals to provide new ideas to those who seek to improve their COPD patient care.

The final report may direct future guidelines and research and provide evidence to support arguments for better organisation of care and adequate resources within countries and throughout the continent.

More information

The COPD audit project is lead by the European Respiratory Society (ERS) and Steering Group. The members of the Steering Group for this COPD audit are: Prof. Michael Roberts (UK), Dr. Sylvia Hartl (Austria), Dr. José Luis López-Campos (Spain).

The European Respiratory Society is represented by Moniek Haan, Project Manager COPD Audit.

Progress of the ERS COPD Audit (March 2011)

If you would like to stay updated on the ERS COPD Audit developments, join the ERS COPD Audit LinkedIn network group, follow the ERS COPD Audit on Twitter and Facebook.

New Partners of Respiratory Decade

We are proud to present you 2 new partners of Respiratory Decade:

COPD-ALERT

COPD-ALERT provides support for lung disease (COPD) patients and takes part in worldwide campaign for recognition of dangerous rise in prevalence of COPD. It actively supports the Global Obstructive Lung Disease (GOLD) Initiative, which aims to raise awareness of the increasing burden of COPD, decrease morbidity and mortality, promote further study of the condition, and implement programs to prevent COPD. COPD-ALERT is actively involved in advocacy activities on the national and local levels.
COPD-ALERT is a member of the National Heart, Lung, and Blood Institute Public Interest Organizations, American Thoracic Society Public Advisory Roundtable as well as of the US COPD and International Coalitions.

The Asthma & Diet Association of America

The Asthma & Diet Association of America is dedicated to providing patients, with cutting edge information on asthma with a focus on how diet can and does affect asthma. The Asthma & Diet Association of America strives to provide a place to learn about asthma, and most importantly, what patients can do about it.

At the Asthma & Diet Association of America we believe that there is a life beyond asthma and that even if you have asthma, you can live a healthy normal life. We hope that the information you find here will help empower you to make healthy lifestyle choices that will help you be, feel, and stay healthy.

2011 International Guidelines on Rhinitis, Asthma and COPD: Italian Update of Global Initiatives ARIA, GINA and GOLD

I would like to share with you my experience and impressions about the Congress International Guidelines on Rhinitis, Asthma and COPD Global Initiatives ARIA, GINA and GOLD, which took place in Modena, Italy at 1-3 March 2011.

The main topics of the Congress were chronic respiratory diseases and comorbidities. Comorbidities markedly affect health outcomes in COPD, asthma and allergic rhinitis.

         Leonardo M. Fabbri, world known Professor of Respiratory Diseases and President of European Respiratory Society (2008) is also President of LIBRA (Linee Guida Italiane per BPCO, Rinite e Asma). LIBRA is an Italian scientific organization working on guidelines on COPD, asthma and rhinitis that is why it was the organizer of the event.

             

1^st  Day of the Congress was dedicated to asthma and allergic rhinitis.

While his presentation Professor Jean Bousquet, (France) answered a very important question: Is a uniform definition of chronic disease severity and control possible? Thereupon Prof. Klaus F. Rabe (Germany), 2012 President of European Respiratory Society, talked about Pathophysiology of severe asthma.

There was organized a special session on present and future treatments for severe asthma and comorbidities with presentations of leaders in respiratory care - Professors Neil Barnes (UK), Eric Bateman, President of GINA Executive Committee (South Africa) and Paul M. O’Byrne (Canada).

In the evening there was a round table dedicated to the development of new treatments for asthma and COPD with very exciting presentations:

-          Giorgio W. Canonica (Italy) Unmet needs in asthma and COPD;

-           Ian Adcock (UK) Role of academic research for the development of new drugs;

-           Thierry Troosters (Belgium) Development and validation of new patient related outcomes. 

Numerous interactive sessions were hold during the Congress – teleconferences with well known specialists:

· Peter J. Sterk (Netherlands) presented Phenotyping severe asthma in adults: the u-biopred project;

· Alvar Agusti from Barcelona presented his radical new approach to the respiratory patient in his perfect lecture System medicine and COPD;

· Fernando J. Martinez presented Phenotyping severe COPD.

Prof. Lorenzo Corbetta, National Italian Leader of the GOLD with National Moldavian Leader of the GOLD, Doctor Alexandru Corlateanu discuss the success of the Year of the Lung and ponder on the future of Respiratory Decade.

2^nd Day of the Congress was dedicated to COPD.

Comorbidities such as chronic heart failure, cardiovascular disease, depression, diabetes, muscle wasting, weight loss, lung cancer, and osteoporosis can frequently be found in patients with COPD and are considered to be part of the commonly prevalent nonpulmonary sequelae of the disease. Considering that the pharmacological treatment of COPD to date is primarily symptomatic, a more comprehensive approach to comorbidities may provide an opportunity to modify the natural history of patients with COPD and to identify novel targets for treatment.

            There were 3 sessions: COPD phenotyping, importance of comorbidities for COPD phenotyping and management of COPD and comorbidities. David M. Mannino from USA presented Epidemiology of complex chronic comorbidities of COPD. Claus Vogelmeier (Germany) presented

Diagnosis and assessment of severity of the patient with COPD and chronic comorbidities.

President of GOLD Executive Committee Professor Roberto Rodríguez-Roisin (Spain) made presentation “Increased Peripheral Neutrophil Stiffness in COPD: Is it relevant?” Jorgen Vestbo (Denmark) presented COPD in patients with chronic diseases and Peter Calverley (UK) Pharmacologic management COPD in patients with chronic comorbidities

3rd Day of the Congress was dedicated to Italian Update of Global Initiatives ARIA, GINA and GOLD.

There were 3 working group sessions: chaired by Professsor Giovanni Passalacqua (ARIA), Professsor Pierluigi Paggiaro (GINA) and Professsor Lorenzo Corbetta (GOLD).

            As we discussed with Lorenzo Corbetta, all presentations will be uploaded and available in a short time.

Another result of the Congress is the meeting with Doctor Gloria Montanari from Modena University, Italy. She is one of the most active members of Year of the Lung and Respiratory Decade. We discussed the perspective of our initiative and we aim at further collaboration. 

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) works with health care professionals and public health officials to raise awareness of Chronic Obstructive Pulmonary Disease (COPD) and to improve prevention and treatment of this lung disease for patients around the world. Through the development of evidence-based guidelines for COPD management, and events such as the annual celebration of World COPD Day, GOLD is working to improve the lives of people with COPD in every corner of the globe.

Finally we would like to thank LIBRA and its President, Prof. L. M. Fabbri for a successful Congress and remarkable annual organization which allowed taking part in different discussions, to acquire useful information and to establish relations with international specialists.