AbstractsBiology & Animal Science

BACKGROUND The epidemics of non-communicable diseases and the need for cost-containment are triggering a profound reshaping of healthcare delivery toward adoption of the Chronic Care model, involving deployment of integrated care services (ICS) with the support of information and communication technologies (ICS-ICT). In this scenario, emerging systems medicine, with a holistic mechanism-based approach to diseases, may play a relevant role in health risk assessment and patient stratification. The general aim of Synergy-COPD was to explore the potential of a systems medicine approach to improve knowledge on underlying mechanisms of chronic obstructive pulmonary disease (COPD) heterogeneity, focusing on systemic effects of the disease and co-morbidity clustering. The transfer of acquired knowledge to healthcare was also a core aim of the project. Moreover, Synergy-COPD explored novel cross talk between biomedical research and healthcare to foster deployment of 4P (Predictive, Preventive, Personalized and Participatory) Medicine for patients with chronic disorders. The current PhD thesis contributed to Synergy-COPD focusing on two specific areas: i) a quantitative analysis of the relationships between cellular oxygenation and mitochondrial reactive oxygen species (ROS) generation; and, ii) different ICT developments addressing transfer of knowledge to healthcare and the interplay with biomedical research. HYPOTHESIS The overarching hypothesis of this PhD thesis is that subject-specific health risk assessment and stratification may lead to novel and a more efficient patient-oriented healthcare delivery. Specifically, the current PhD studies hypothesize that predictive mechanistic modeling integrating oxygen pathway and mitochondrial function can contribute to assess the biological effects of cellular hypoxia and its role on skeletal muscle dysfunction in COPD. Moreover, it is hypothesized that a holistic design of the ICT support may contribute to a successful deployment of ICS-ICT for chronic patients fostering the transfer of the achievements of systems-oriented research into healthcare. OBJECTIVES To integrate physiological modeling of the O2 pathway and biochemical modeling of mitochondrial ROS generation to quantitatively analyze the relationships between skeletal muscle oxygenation and mitochondrial ROS generation. To develop ICT tools supporting Integrated Care Services (ICS-ICT) for chronic patients, as well as innovative cross talk between systems-oriented biomedical research and healthcare. MAIN FINDINGS Quantitative analysis between cellular oxygenation and mitochondrial ROS generation The model analyzed the role of all the physiological determinants of the O2 pathway. It was shown that a given degree of heterogeneity in the skeletal muscle reduces overall O2 transfer more than does lung heterogeneity, but actually observed heterogeneity in lung is greater than in muscle, so that lung heterogeneity has a greater impact on overall O2 transport. In addition, muscle heterogeneity showed…