Lifelong smoking is the most important risk factor for developing Chronic Obstructive Pulmonary Disease (COPD) at an older age, yet only 20-30% of the smokers are truly at risk. This susceptibility appears to be dependent of a person's genetic makeup.

When studying fully established COPD at older age, a complex network of inflammatory cells and substances in the lung can be identified. However, the key players responsible in the development of COPD are unknown. By comparing young and older subjects who are either susceptible or not susceptible of developing COPD, the partners of this project aim to find the most important genes, cells and substances that determine this susceptibility. In particular, the inflammatory response to acute smoking in young susceptible subjects may provide important clues about the very first manifestations and origin of COPD. Eventually, the knowledge gained in this project can be used to develop early warning systems for people susceptible to COPD, and for the development of effective medication for COPD.

Fast facts
Full project title: Acute and chronic inflammatory response
Start date: January 2008
End date: September 2012
Goal: The development of biological markers in blood, sputum, epithelial lining fluid and exhaled breath to characterise the induction and progression of local and systemic inflammation in COPD in relation to the underlying genetic makeup.
Principal investigator: Nick ten Hacken, UMCG
Project size: 10 FTE's
Partners: GlaxoSmithKline, Nycomed, University Medical Center Groningen, University Medical Center Utrecht, University of Groningen


Chronic obstructive pulmonary disease (COPD) is a lung disease which constitutes a major public health problem. The disease ranks fourth on the list of potentially fatal disease in the Netherlands, with 6000 deaths annually and 320.000 current patients. Patients with COPD have narrowed airways due to an inflammation, which results in breathing difficulties and shortness of breath. In severe cases, the lungs are permanently damaged. Symptoms include chronic coughs, a rapid breathing rate, wheezing, frequent colds, and chest tightness. 

In principal, COPD is similar to Asthma. The main difference is that Asthma can be controlled with drugs, while COPD cannot. COPD manifests itself slowly. This can impede proper treatment of the disease because most people consider the first symptom, shortness of breath, as just that and adjust their behaviour accordingly. Inhalation of pollution, dust or chemicals contribute to, and sometimes cause, COPD, but smoking is reported as the most important cause. In rare cases the disease is the result of a genetic disorder. It is estimated that the number of patients will increase in the future, as it is predicted that COPD will be one of the top five leading causes of death in 2020. 

PhD theses from this project

Susan Hoonhorst (project T1-108)
COPD: recognizing the susceptible smoker

“TI Pharma's partnerships result in a synergy that really drives the science further than the individual parties could achieve working alone.”

Jan Raaijmakers
Past VP External Scientific Collaborations GSK Europe
Chair TI Pharma Board of Directors

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