04. Systems Epidemiology

Josep M. Antó.
Centre for Research in Environmental Epidemiology (CREAL) IMIM, UPF, CIBERESP


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An Epidemiological View


Josep M. Antó.
Centre for Research in Environmental Epidemiology (CREAL) IMIM, UPF, CIBERESP


Epidemiology can be defined as the population based approach to health and disease. Starting with epidemiological studies on smoking in early fifties, modern epidemiology as evolved to a mature field based on the observational design, a computational model of exposure-disease associations and the use of criteria of causality. The study of biological mechanisms trough molecular epidemiology has become common. Though epidemiology has enormously contributed to public health and clinical medicine it has progressively encountered important limitations including the following: confounding and measurement error of small effects, reverse causation, single risk factors vs. combined effects (interactions), phenotype overlap (comorbidity), phenotype heterogeneity (subphenotypes) and the discordance between randomized and observational studies. Taking into account the importance of these limitations is was not a surprise that many epidemiologist embraced genomics with hope. The genome and postgemome respiratory epidemiology has evolved very fast trough the GWAs studies, the assessment of gene-environment interactions, the epigenetics and the other omics. These developments have provided new insights on causal mechanisms and have stimulated research and conceptual frameworks on the use of genetics for screening a filed usually described as personal genomics or genomic medicine. The exponential increase on the molecular and OMIcs studies has, however, increased the complexity of the available knowledge while has not resulted on better strategies for prevention and treatment of chronic respiratory diseases. The increasing concern for the unresolved complexity has led some epidemiologists to look to systems biology as an opportunity for more successful integrative strategies. Several traditional fields in epidemiology like multilevel studies and use of longitudinal methods for temporal dynamic relationships can now benefit of new bioinformatics’ tools and the broader perspective of systems biology. Finally, and most important, the current translation of systems biology into systems medicine offers the opportunity for epidemiology to contribute with relevant warnings and potential solutions including their capacity to integrate social, environmental and biological determinants and to complement population and individual based approaches.

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Josep M. Antó received his Degree in Medicine in 1975 and his PhD in 1990 (EpidemiologicalInvestigations of Asthma Epidemics; Extraordinary Award). He has been working at the IMIM (Hospital del Mar Medical Research Institute) (1988‐2005) where as Chair of the Respiratoryand Environmental Health Research Unit (1996‐2005) and Director (2004‐2005). He has been Principal Visiting Fellow at the National Heart and Lung Institute (1994, London, UK). He is currently the Director of Centre for Research in Environmental Epidemiology (CREAL). Since
1998 he is Professor of Medicine at the Universitat Pompeu Fabra (UPF). He has been a member of the advisory and editorial boards in several journals including the American Journal of Epidemiology, Thorax, European Journal of Public Health (current) and European Respiratory Journal. Among other awards he has received the Cournant Lecture (European Respiratory Society, 1994), the Manuel Tapia Conference (Spanish Association of Respiratory Pathology, 1999) and the Medals Narcis Monturiol and Josep Trueta (Generalitat de Catalunya, 1995 and 2009).
His current research is focused on the epidemiology of asthma and COPD two areas on which his work has had a significant international impact. Currently, he is the co‐leader and scientific coordinator of a large collaborative project to identify the mechanisms of allergy in children (MeDALL‐FP7 2011‐14), which is developing the knowledge base for a systems approach to be applied in birth cohort studies (Antó, JACI 2012; Pinart, Lancet Resp Med 2014).

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