There is an urgent need for developing a Precision Center of Excellence for COPD research to catapult our patient care and prevention effort for reducing hospitalization and improve treatment and prevention of the disease. In absence of a center, there is lack of coordination between infrastructure and the research and clinical activities occur in silos, limiting our forward progress.
COPD is ideal for precision medicine, as it is a complex syndrome representing several disorders with a range of clinical susceptibilities, phenotypes, severity, progression, exacerbation and responses to current therapeutic agents. A NHLBI 2014 consensus statement raised the importance of identifying subphenotypes of COPD. The formation of a Precision Center of Excellence can forge the way to identify and categorize patients into clinically relevant subgroups by detailed acquisition of clinical data and outcomes and relevant characteristics over time. These clinical phenotypic data can be coupled to radiographic and biomarker data using collected biospecimens, and leveraged to study the biological underpinnings of COPD heterogeneity and progression. The clinical activity in the area of COPD at Johns Hopkins includes a dedicated Obstructive Lung Disease outpatient clinic with a significant out-of-state draw, as well as a substantial patient volume in general medicine and general pulmonary clinics.
As the Director of the Biorepository, we are currently enrolling our COPD patient to collect urine, blood, sputum, nasal epithelial and bronchial epithelial cells from patients with well-characterized disease. The goal is to identify characteristics which portend worse prognosis as well as identify pathways for novel therapeutics.