Chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is characterised by progressive airflow obstruction that is only partly reversible, inflammation in the airways, and systemic effects or comorbities. The main cause is smoking tobacco, but other factors have been identified. Several pathobiological processes interact on a complex background of genetic determinants, lung growth, and environmental stimuli. The disease is further aggravated by exacerbations, particularly in patients with severe disease, up to 78% of which are due to bacterial infections, viral infections, or both. Comorbidities include ischaemic heart disease, diabetes, and lung cancer. Bronchodilators constitute the mainstay of treatment: β(2) agonists and long-acting anticholinergic agents are frequently used (the former often with inhaled corticosteroids). Besides improving symptoms, these treatments are also thought to lead to some degree of disease modification. Future research should be directed towards the development of agents that notably affect the course of disease.
Respiratory Division, University Hospital, University of Leuven, Leuven, Belgium. marc.decramer@uzleuven.be
Marc
M
Decramer
Wim
W
Janssens
Marc
M
Miravitlles
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D056151:Airway Remodeling / Q000502:physiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015897:Comorbidity; D004359:Drug Therapy, Combination; D020022:Genetic Predisposition to Disease; D006801:Humans; D016040:Lung Transplantation; D018384:Oxidative Stress; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D012129:Respiratory Function Tests; D012138:Respiratory Therapy; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation; D013183:Sputum / Q000382:microbiology
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D015415:Biomarkers; D001993:Bronchodilator Agents