What is the pathogenesis and appropriate treatment for subjects with chronic respiratory symptoms or imaging abnormalities who do not have overt airflow obstruction (and thus are not currently categorized as having COPD)?

What are the subtypes of chronic obstructive lung disease that share a common pathogenesis and can be a basis for precision medicine?

What are the biomarkers that identify expression and progression of specific subtypes of chronic lung disease?

How can chest CT or other imaging tools be optimally used to characterize expression and progression of chronic lung disease?

Integration of multiple Omics data types (genetics, transcriptomics, metabolomics, proteomics, and epigenetics) to understand susceptibility, progression, and heterogeneity of chronic lung diseases.

Asthma-COPD overlap syndrome is common and associated with increased morbidity and greater healthcare costs. However, ACOS patients are usually excluded from studies of either disease. There is a compelling need for research in order to define objective diagnostic criteria for ACOS.

What is the nature of, and what are the best treatments for, heart failure in COPD?

Develop large epidemiologic cohorts of subjects with various types of chronic lung diseases with long-term follow-up of elements of disease progression and of related co-morbidities. These cohorts should be the substrate for comprehensive studies of genetics, omics, and biomarkers, as well as for clinical trials.

1) Refinement of COPD subphenotypes for therapeutics, diagnostics and mechanistic interrogation. The NIH should encourage a strong focus on a) rigorous, mechanistically-reinforced definitions (chronic bronchitis, emphysema (with and without obstruction), frequent exacerbators, combined pulmonary fibrosis and emphysema) and 2) the development and optimization of animal model systems that replicate the different subphenotypes.... more »

What is the comparative effectiveness of short-term vs. chronic (e.g. 12 mos) pulmonary rehabilitation on survival, patient-reported outcomes (symptom frequency, activities of daily living, quality of life, sleep quality, exacerbations), healthcare utilization, and costs from a societal and healthcare system perspective?

COPD is a major health problem with more than 140,000 deaths per year and yet there is a relative paucity of treatments that might modify the course of this disease. In part, this is due to the poor efficiency of animal models that require months of exposure to cigarette smoke. Moreover, there are no well validated small animal models of chronic mucus hypersecretion. Funding of core facilities that could both provide... more »

What does early COPD actually look like. This is defined as severe COPD 30 years prior to its manifestation.

Chronic obstructive pulmonary disease (COPD) affects over 12-24 million individuals in the U.S. where it is responsible for ~ 800,000 hospitalizations per year, and recently became America’s 3rd leading cause of death. The lag between clinical practice and treatment options described by efficacy studies to improve the quality of life, functional status, and survival in patients with COPD make it ideal for efforts in patient-centered... more »

Society is ageing and chronic degenerative diseases including COPD are increasingly occurring together.
The critical question is whether certain diseases occur together by chance or are they occurring together because they share pathobiological commonalities and mechanisms? This leads to a series of practical consequences and questions
1. Which diseases are occurring concurrent with COPD more than chance alone would... more »

How to "cure" a chronic, incurable disease - A potential giant step in saving the lives of many thousands of Americans, and potentially millions worldwide, who are afflicted with COPD, the third leading cause of death in the U.S.
The financial effect of COPD in the United States alone is well over $50 billion per year. It is estimated that some 30 million Americans have COPD, which of course means that at least that... more »