Asthma as a nonlinear complex dynamic system: a novel approach to understand the temporal behaviour of chronic asthma and its response to -agonists

Abstract

I am a paediatric pulmonologist, Professor and Head of the Division of Paediatric Respiratory Medicine at the University Children's Hospital in Bern, Switzerland. I graduated in 1989, wrote my MD thesis in paediatrics and trained as a paediatrician in Bern. I then spent some time in research and clinical training at Boston University (Boston, MA, USA), Hammersmith Hospital (London, UK) and Leicester University (Leicester, UK) and wrote a PhD in medical physics/biomedical engineering. My major research interests include the developmental physiology of newborns with wheezing disorders and asthma, and the potential role of environmental pollutants in lung growth and development. I was also involved in the development of new noninvasive lung function and nitric oxide measurement tests in infants. Such tests can be carried out in unsedated infants during natural sleep, and facilitate lung function studies in larger healthy cohorts and early recognition of infants at risk for later wheezing disorders and asthma. I was also significantly involved in the European Respiratory Society (ERS)/American Thoracic Society standardisation of infant lung function testing. My research has been supported by the Swiss National Science Foundation and by ERS long-term research fellowships. In 1999, I won the ERS Paediatric Respiratory Research in Europe Award and, in 2003, the Swiss Theodor-Kocher Research Award. The structure as well as the function of the respiratory system is complex. It includes subsystems involved in host defence, immunity and inflammation, as well as lung mechanics; these are inhomogeneous and irregular. More importantly, none of these subsystems function independently of each other but are highly interlinked, constituting a network with various tiers ranging from the molecular through cellular to organ level. Additional interactions occur within the organism, as well as within the external environment. Most studies that have led to advances in the understanding of the pathophysiology of the …