Chronic obstructive pulmonary disease subpopulations and phenotyping

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:141

Review

Segal, Leopoldo N.¹  Martinez, Fernando J.² 

[1] NYU, Sch Med, Div Pulm & Crit Care Med, New York, NY 10003 USA

[2] Cornell Univ, Joan & Sanford Weill Med Coll 1, Div Pulm & Crit Care Med, Ithaca, NY 14853 USA

关键词: Chronic bronchitis;    emphysema;    asthma;    chronic obstructive pulmonary disease;    inflammation;    exacerbation;    computed tomographic scan;    microbiome;   

DOI  :  10.1016/j.jaci.2018.02.035

来源: Elsevier

【 摘 要 】

The diagnosis and treatment of chronic obstructive pulmonary disease (COPD) has been based largely on a one-size-fits-all approach. Diagnosis of COPD is based on meeting the physiologic criteria of fixed obstruction in forced expiratory flows and treatment focus on symptomatic relief, with limited effect on overall prognosis. However, patients with COPD have distinct features that determine very different evolutions of the disease. In this review we highlight distinct subgroups of COPD characterized by unique pathophysiologic derangements, response to treatment, and disease progression. It is likely that identification of subgroups of COPD will lead to discovery of much needed disease-modifying therapeutic approaches. We argue that a precision approach that integrates multiple dimensions (clinical, physiologic, imaging, and endotyping) is needed to move the field forward in the treatment of this disease.

【 授权许可】

Free