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Unravelling the mechanisms driving multimorbidity in COPD to develop holistic approaches to patient-centred care

Unravelling the mechanisms driving multimorbidity in COPD to develop holistic approaches to patient-centred care
Unravelling the mechanisms driving multimorbidity in COPD to develop holistic approaches to patient-centred care

COPD is a major cause of morbidity and mortality worldwide. Multimorbidity is common in COPD patients and a key modifiable factor, which requires timely identification and targeted holistic management strategies to improve outcomes and reduce the burden of disease. We discuss the use of integrative approaches, such as cluster analysis and network-based theory, to understand the common and novel pathobiological mechanisms underlying COPD and comorbid disease, which are likely to be key to informing new management strategies. Furthermore, we discuss the current understanding of mechanistic drivers to multimorbidity in COPD, including hypotheses such as multimorbidity as a result of shared common exposure to noxious stimuli (e.g. tobacco smoke), or as a consequence of loss of function following the development of pulmonary disease. In addition, we explore the links to pulmonary disease processes such as systemic overspill of pulmonary inflammation, immune cell priming within the inflamed COPD lung and targeted messengers such as extracellular vesicles as a result of local damage as a cause for multimorbidity in COPD. Finally, we focus on current and new management strategies which may target these underlying mechanisms, with the aim of holistic, patient-centred treatment rather than single disease management.

0905-9180
Burke, H.
a9bb9391-4704-4584-aeb7-e69fe0acbdb8
Wilkinson, T. M.A.
8c55ebbb-e547-445c-95a1-c8bed02dd652
Burke, H.
a9bb9391-4704-4584-aeb7-e69fe0acbdb8
Wilkinson, T. M.A.
8c55ebbb-e547-445c-95a1-c8bed02dd652

Burke, H. and Wilkinson, T. M.A. (2021) Unravelling the mechanisms driving multimorbidity in COPD to develop holistic approaches to patient-centred care. European Respiratory Review, 30 (160), [210041]. (doi:10.1183/16000617.0041-2021).

Record type: Article

Abstract

COPD is a major cause of morbidity and mortality worldwide. Multimorbidity is common in COPD patients and a key modifiable factor, which requires timely identification and targeted holistic management strategies to improve outcomes and reduce the burden of disease. We discuss the use of integrative approaches, such as cluster analysis and network-based theory, to understand the common and novel pathobiological mechanisms underlying COPD and comorbid disease, which are likely to be key to informing new management strategies. Furthermore, we discuss the current understanding of mechanistic drivers to multimorbidity in COPD, including hypotheses such as multimorbidity as a result of shared common exposure to noxious stimuli (e.g. tobacco smoke), or as a consequence of loss of function following the development of pulmonary disease. In addition, we explore the links to pulmonary disease processes such as systemic overspill of pulmonary inflammation, immune cell priming within the inflamed COPD lung and targeted messengers such as extracellular vesicles as a result of local damage as a cause for multimorbidity in COPD. Finally, we focus on current and new management strategies which may target these underlying mechanisms, with the aim of holistic, patient-centred treatment rather than single disease management.

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More information

Published date: 1 June 2021
Additional Information: Funding Information: Conflict of interest: H. Burke has nothing to disclose. T.M.A. Wilkinson reports personal fees and other funding from MMH, grants and personal fees from GSK, AstraZeneca and Synairgen, and personal fees from Boehringer Ingelheim, outside the submitted work. Publisher Copyright: © The authors 2021. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

Identifiers

Local EPrints ID: 450822
URI: http://eprints.soton.ac.uk/id/eprint/450822
ISSN: 0905-9180
PURE UUID: d438af28-573f-415a-8cee-e93c59cb7f13

Catalogue record

Date deposited: 12 Aug 2021 16:32
Last modified: 25 Nov 2021 17:02

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Author: H. Burke

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