title: Lung microbiology and exacerbations in COPD.
abstract: Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory condition in adults and is characterized by progressive airflow limitation that is not fully reversible. The main etiological agents linked with COPD are cigarette smoking and biomass exposure but respiratory infection is believed to play a major role in the pathogenesis of both stable COPD and in acute exacerbations. Acute exacerbations are associated with more rapid decline in lung function and impaired quality of life and are the major causes of morbidity and mortality in COPD. Preventing exacerbations is a major therapeutic goal but currently available treatments for exacerbations are not very effective. Historically, bacteria were considered the main infective cause of exacerbations but with the development of new diagnostic techniques, respiratory viruses are also frequently detected in COPD exacerbations. This article aims to provide a state-of-the art review of current knowledge regarding the role of infection in COPD, highlight the areas of ongoing debate and controversy, and outline emerging technologies and therapies that will influence future diagnostic and therapeutic pathways in COPD.
authors.affiliation: Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Beasley
authors.forename: Priya V
authors.initials: PV
authors.lastname: Joshi
authors.forename: Aran
authors.initials: A
authors.lastname: Singanayagam
authors.forename: Philip L
authors.initials: PL
authors.lastname: Molyneaux
authors.forename: Sebastian L
authors.initials: SL
authors.lastname: Johnston
authors.forename: Patrick
authors.initials: P
authors.lastname: Mallia
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004195:Disease Models, Animal; D018450:Disease Progression; D006801:Humans; D008168:Lung / Q000382:microbiology* / Q000503:physiopathology / Q000821:virology*; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy / Q000821:virology; D012141:Respiratory Tract Infections / Q000150:complications* / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy / Q000821:virology; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents