Community Research and Development Information Service - CORDIS


ALEC Report Summary

Project ID: 633212
Funded under: H2020-EU.3.1.1.

Periodic Reporting for period 1 - ALEC (Aging Lungs in European Cohorts)

Reporting period: 2015-05-01 to 2016-10-31

Summary of the context and overall objectives of the project

Our project will improve our understanding of the factors that influence lung health as people get older. It will use and combine information that has already been collected across Europe and in Australia in large surveys (cohort studies) in which many thousands of people have provided information on their respiratory symptoms and had their lung function tested over many years of follow-up.

Lung function is a good measure of lung health, strongly associated with other major chronic diseases and a major independent determinant of overall health status. As adults age there is a ‘natural’ age-related loss of lung function (or ‘lung function decline’), but in some people this decline is excessive, being up to five times faster than in their healthier peers. Individuals with excess lung function decline will develop clinical symptoms, increasing respiratory disability, and objective markers typical of chronic obstructive lung disease (COPD). Even though COPD has long been viewed as a predominantly smoking-related disease, many people with lung function abnormalities have never smoked, and there is increasing awareness that other factors must contribute to disease.

COPD is a major cause of disease, disability and death in European adults, and is of particular relevance to the changing demographic patterns and ageing of the European population because it will become more common in European nations as their populations age. Asthma, a disease which, in most parts of Europe, has shown at least a 2-3 fold increase in prevalence over the last 60 years, may contribute to low lung function, respiratory disability and COPD.

The broad objectives of our project are to

1. identify determinants and risk factors (behavioural, environmental, occupational, nutritional, other modifiable lifestyle, genetic) of poor lung growth, excess lung function decline and occurrence of low lung function, respiratory disability and COPD

2. generate new data to fill gaps in knowledge on pre-conception and transgenerational determinants

3. use available blood samples to examine change in DNA methylation patterns and identify epigenetic changes associated with poor lung health and exposure to disease risk factors

4. strengthen the evidence that identified risk factors are causally associated with disease by using data from many different sources, integrating data from the cohort-related population-based biobanks and exploiting modern statistical techniques

5. generate a predictive risk score for individual risk stratification of COPD that takes account of the combined effects of factors that cause poor lung growth, low maximally attained lung function and lung function decline

6. develop an online interactive tool that can be used to assess risk and make it freely and widely available to the population, patients and health care providers

7. make recommendations on COPD research priorities

Our work will provide an evidence base for identifying individuals and populations at risk of poor lung health and will underpin future preventive and therapeutic strategies and policies. We will be able to assess the potential impact of public health strategies to reduce exposure to key risk factors for poor lung function and COPD, hallmarks of disability and accelerated biological ageing

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

During the first eighteen months of this project we have
1) Collected and collated information on the health of multiple generations within the same family by using registry based information, inviting families for further lung function tests and health questionnaires and combining it with data that is already available on the participants of some of the cohort studies
2) Developed sophisticated statistical methods to analyse multigenerational health and risk factor data and completed analyses indicating that smoking by young boys in their early teenage years, and by a child’s grandmother when she is pregnant with their mother, is associated with asthma in the child
3) Combined information across the cohorts to examine childhood factors associated with lung function measured at or around the time when lung function should be at its highest
4) Integrated genetic information with health information to determine whether the genes that determine age of menarche in girls, are also associated with lung function growth – this work indicated that early age of menarche is associated with lower lung function
5) Combined data across the cohorts to identify where there may be some differences in the detail of information across the cohorts and developed sophisticated statistical techniques to impute data when it is missing in a health data set – this will assist with the later work in the study
6) Shown that being physically active is beneficial for lung function
7) Tested samples of blood to examine DNA methylation in 1000 people who provided samples on 2 occasions over a 10 year period, and conducted preliminary quality control analyses which confirm these samples will provide valid and novel information on longitudinal change in DNA methylation in adults as they age
8) Using information from all the participating cohorts, examined smoking trends in the populations to look at the effect of age and period and cohort. We have shown that smoking initiation in young teenage boys has not fallen over the last years and is an ongoing problem
9) Identified organisations that have an interest in lung health (charities, scientific organisation, patients organisation) and told them about our study directing them to our website
10) Presented our work at conferences and prepared and submitted papers for publication

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

This is one of the largest consortia of cohort studies within Europe that has information on respiratory health which is very detailed information and has been collected over a prolonged period of time. We have developed novel statistical methods that are state-of the art for multigenerational analysis, and constructed a database of health information from multiple generations within the same family to test hypotheses regarding the inheritance of disease across generations. Our work on the relationship of early age of menarche and lung function has demonstrated the application of state-of-the-art statistical methods to show how genetic information can be used as proxies to identify causes of low lung function. We have used state-of-the-art statistical methods to deal with data that may be missing within the cohorts. These steps allow a more comprehensive assessment of the factors that influence COPD, lung function growth and decline and respiratory symptoms, and will underpin later work in the ALEC project directed towards the development of a risk score.
We have advanced our understanding of the combined effect of multiple factors on lung health, which is relevant for all European citizens. Our work showing that adolescent boys have not decreased their smoking rates, and that smoking by adolescent males may be associated with poor respiratory health in their children is of critical relevance to public health professionals and to those examining health trends in future generations.

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