Foreword.qxp 11/8/09 2:34 pm Page 8
Foreword
Robert A Stockley is a Professor of Medicine in the Department of Respiratory Medicine at Queen Elizabeth Hospital, University
Hospitals Birmingham, and Director of Research and Development for the Trust. He has a long-standing interest in chronic obstructive
pulmonary disease (COPD), with particular reference to airway inflammation, proteinases and antiproteinases, especially the role of the
neutrophils, bacteria and exacerbations; he lectures widely on these subjects. Professor Stockley acts as an advisor to many
pharmaceutical companies on the design and delivery of phase II and III clinical trials and has been the principal investigator for several
large multinational COPD trials. He organises the UK alpha-1-antitrypsin deficiency registry and established the international registry for
the deficiency, and is currently co-ordinating multicentre trials of augmentation therapy and alveolar regeneration in these patients.
W
elcome to this issue of European Respiratory Disease. This publication strives to address important
advances and issues in the field of respiratory diseases, and the papers included have been selected for
their significance and substance in this interesting and important area. The result is a collection of outstanding
articles that discuss and review many of the important issues faced by respiratory specialists throughout Europe
every day.
The rapidly expanding science of pathophysiology, biomarkers and drug discovery has long been held up by reliance
on forced expiratory volume in one second (FEV
1
) as the primary outcome measure in both phase II and phase III
clinical trials. In the absence of significant bronchodilator reversibility, physiological outcomes for new therapies
based on anti-inflammatory properties have led to the early cessation of several promising avenues of therapy.
Nevertheless, the role and utilisation of biomarkers to provide reassuring early markers of efficacy has yet to emerge.
A structured approach that rises above enthusiasm and the availability of multiple test methodologies are needed.
The engagement of clinicians, scientists, industry and, particularly, the regulatory authorities is needed if we are to
take the next step forwards in drug development for chronic diseases. Meanwhile, there is still an important place
for clinical studies that enhance our management of patients today.
This issue of European Respiratory Disease opens with features on asthma, examining prevention, control and
management. The opening section provides updates on the diagnosis and treatment of asthma in both children and
adults. There are interesting articles questioning the role of spirometry screening, and the chronic obstructive
pulmonary disease (COPD) section concludes by looking at the treatment of acute exacerbations. The increasing role
of smoking cessation is also addressed, with pharmacological interventions and pharmacogenetic trials for the
treatment of nicotine dependence both discussed in detail. The article on allergic rhinitis examines techniques and
devices to manage grass-pollen-induced allergic rhinitis. The important areas of pleural disease and malignant
pleural effusion are addressed, with articles on the prevention, diagnosis and treatment of the respiratory disorder.
Other key topics such as cystic fibrosis and pneumonia are also included, with particular focus on the role of
methicillin-resistant Staphylococcus aureus in cystic fibrosis. The section on pneumonia looks at the importance of
prevention and treatment of hospital-acquired pneumonia.
European Respiratory Disease would like to thank everyone involved in this issue for achieving such an insightful and
thought-provoking collection of articles worthy of debate and attention. We would like to thank all organisations
and media partners for their continued support, and also extend our gratitude to the individual authors for their
time and effort, which has resulted in a selection of excellent articles. We trust you will find this issue an informative
and enjoyable read. ■
8 © TOUCH BRIEFINGS 2009
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