Chronic Obstructive Pulmonary Disease: Reactive Past, Preventive Future

An International Conference, ‘‘COPD: Reactive Past Preventive Future,’’ was held in Vancouver, Canada, February 6–7, 2009, to celebrate the 30th anniversary of the pulmonary research group at the James Hogg iCAPTURE Center and to map out the future of research in chronic obstructive pulmonary disease (COPD) for the next generation of researchers. Approximately 150 researchers and clinicians from three continents (Asia, Europe, and North America) attended this two-day conference, and 26 leading international experts in COPD research spoke, covering all aspects of this devastating disease, from pathophysiolgy, epidemiology, biomarkers, and imaging, to genomics. The essence of these talks is captured in this issue of the Proceedings. This event was also held to honor and celebrate the 30 years of research excellence at the James Hogg iCAPTURE Center. The Center (http://www.icapture.ubc.ca/home.shtml), located at the St. Paul’s Hospital campus of the University of British Columbia (UBC), was founded in the late 1970s with the recruitment of Drs. Hogg and Pare from McGill University. Dr. Hogg’s contributions to our knowledge of COPD began at McGill with his first substantial publication in the New England Journal of Medicine in 1968. This citation classic, ‘‘Hogg JC, Macklem PT, Thurlbeck WM, Site and nature of airway obstruction in chronic obstructive lung disease, N Engl J Med 1968;278:1355–1360’’, was completed while he was a post-doctoral fellow working under the supervision of Drs. Peter Macklem, an outstanding clinician scientist, and the late William Thurlbeck, an accomplished pulmonary pathologist. This article was based on the earlier work of Macklem and Mead concerning the distribution of resistance in the canine lung, and proposed a revolutionary idea that the major site of airway obstruction in COPD was in peripheral airways less than 2 mm in diameter. Dr. Pare was a McGill medical student at that time, who later joined Macklem’s team after completing his residency in respiratory medicine. In the mid-1970s, Drs. Pare and Hogg were approached independently by UBC for jobs in Vancouver. After a lengthy discussion, they decided to move only if they had a chance to establish a (translational) pulmonary research team, similar to the one that had been established at McGill by Macklem and Thurlbeck. This concept was endorsed by both Dr. David Hardwick, who was the Chair of Pathology and Dr. John Dirks, who was the Chair of Medicine at UBC at that time. The St Paul’s Hospital campus of UBC was chosen for this new endeavor because the clinical and pathologic setting provided the opportunity to establish a laboratory dedicated to the study of human disease using clinical pathologic specimens backstopped by cell and animal modeling. In the nearly 40 years that they have worked together, they have shared authorship on more than 90 publications in the peer-reviewed literature on a wide variety of topics, but the study of the pathology and pathophysiology of obstructive airway disease has remained their major focus. This important focus is demonstrated by a recent publication, almost 40 years after Hogg’s pivotal first paper, that provides a definitive description of peripheral airway disease in COPD: ‘‘Hogg JC, Chu F, Utokaparch S, Woods R, Elliott WM, Buzatu L, Cherniak RM, Rogers RM, Sciurba FC, Coxson HO, Pare PD, The nature of small-airway obstruction in chronic obstructive pulmonary disease, N Engl J Med 2004;350: 2645–2653.’’ In honor of its founder, the iCAPTURE Center was renamed James Hogg iCAPTURE for Cardiovascular and Pulmonary Research in 2004. Drs. Hogg and Pare have ensured the lasting legacy of the Center by fortifying its infrastructure through two successful grants from the Canadian Foundation for Innovation (http://www.innovation.ca/en) and by strategically recruiting key personnel, including four Canada Research Chairs (http://www.chairs.gc.ca/web/home_e.asp) in respiration to increase the breadth and scope of respiratory research at the Center. Currently, there are more than 20 respiratory researchers and more than 50 students and post-doctoral fellows at the iCAPTURE Center, working to solve the complex pathophysiology of COPD and to identify novel targets for drug and biomarker discovery. The influence of Drs. Pare and Hogg, however, reaches beyond the walls of Vancouver. They have written scores of papers in peer-reviewed journals, and contributed to many important book chapters and books, including the renowned textbook of respiratory medicine (Fraser and Pare’s Diagnosis of Diseases of the Chest, 4th edition). In their illustrious careers, they have also worked with or trained hundreds of respiratory researchers from all parts of the world, including Japan, Korea, Australia, Chile, Argentina, Mexico, and the United Kingdom. This is exemplified by the speakers at this conference, all of whom had worked with or been influenced by Drs. Hogg and Pare during their careers. Their talks, besides being state of the art summaries, were a testament to their broad and persisting legacy on the field. Finally, the author wishes to thank the members of the organizing committee for their leadership; GlaxoSmithKine, Canada for its financial support; and Ms. Willa Kriebel for putting it all together.

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