P re f a c e C h ro n i c O b s t r u c t i v e Pulmonary Disease
Peter J. Barnes, FRS, FMedSci Editor
Although major progress has been made in understanding COPD, many questions about COPD remain unanswered. We do not understand why only a minority of smokers develop airway obstruction, nor the complex interplay between different risk factors in addition to smoking and biomass smoke exposure. We do not understand how the underlying inflammatory process is linked to pathophysiology and disease progression and the reason inflammation and disease progression persist even after smoking cessation is not understood. The different phenotypes may respond differently to different treatments, but this is poorly understood. Although long-acting bronchodilators have proved to be the most effective therapies so far available, we still do not have treatments that suppress the underlying inflammatory process to prevent disease progression and exacerbations. This suggests that much more research is needed in the future. This issue brings together our current understanding of COPD and provides a sound up-to-date synopsis of the disease that will provide a valuable basis for future research into this devastating disease. I wish to thank all of the authors for their excellent articles and to keeping to the deadlines, and the publishers for putting together this volume.
Clin Chest Med 35 (2014) xiii http://dx.doi.org/10.1016/j.ccm.2013.11.003 0272-5231/14/$ – see front matter Ó 2014 Published by Elsevier Inc.
Peter J. Barnes, FRS, FMedSci National Heart and Lung Institute Imperial College, Dovehouse Street London, SW3 6LY, UK E-mail address: [email protected]
Chronic obstructive pulmonary disease (COPD) is a major global health problem that is increasing throughout the world, especially in developing countries. This increase reflects continuing cigarette smoking, which remains the commonest cause, but also relates to aging populations since COPD is a disease of the elderly and may be regarded as accelerated aging of the lung. In addition to cigarette smoking, other causal mechanisms, such as exposure to biomass fuels, air pollution, and poor nutrition, as well as poverty, are also recognized as contributory risk factors. COPD is now the third most prevalent cause of death in Western countries and its mortality is rising in developing countries. It has now become one of the most frequent causes of hospitalization. Although it is one of the most common chronic diseases, it is still poorly recognized among the general public and among doctors, with over half of the patients undiagnosed and many of the diagnosed cases mistreated. There is a major need to better understand this complex disease, which appears to include many poorly understood phenotypes. It is increasingly recognized that COPD occurs with several comorbidities, including cardiovascular and metabolic diseases and lung cancer, which have a major effect on clinical outcomes and management. This volume brings together current knowledge of COPD, written by international experts, and explores every aspect of the disease from epidemiology, through clinical presentation, to underlying mechanisms and clinical management.
Chronic obstructive pulmonary disease (COPD) is characterized by the progression of irreversible airflow limitation and is a leading cause of morbidity and mortality worldwide. Although several crucial mechanisms of COPD pathogenesis have been studie
COPD is associated with different comorbid diseases, and their frequency increases with age. Comorbidities severely impact costs of health care, intensity of symptoms, quality of life and, most importantly, may contribute to life span shortening. Som
Over the past decade, several non-surgical and minimally invasive bronchoscopic lung volume reduction (BLVR) techniques have been developed to treat patients with severe chronic obstructive pulmonary disease (COPD). BLVR can be significantly efficaci
A frequent-exacerbation phenotype of chronic obstructive pulmonary disease (COPD) exists that is independent of disease severity. Establishment of methods to predict 'frequent exacerbators' is critical. The purpose of this review is to critically ass
Chronic obstructive pulmonary disease (COPD) is a lifestyle-related chronic inflammatory pulmonary disease associated with significant morbidity and mortality worldwide. COPD is associated with various comorbidities found in all stages of COPD. The c
Chronic obstructive pulmonary disease (COPD) is a complex disease with both environmental and genetic determinants, the most important of which is cigarette smoking. There is marked heterogeneity in the development of COPD among persons with similar
Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by airway obstruction and inflammation but also accompanied by several extrapulmonary consequences, such as skeletal muscle weakness and osteoporosis. Skeletal muscle weakne