Future perspectives in COPD

• Published in: Respiratory medicine Vol. 99; pp. S41 - S48
• Main Authors: Celli, Bartolome, Goldstein, Roger, Jardim, José, Knobil, Katharine
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford Elsevier Ltd 01.12.2005; Elsevier; Elsevier Limited
• Subjects: Adrenergic beta-Agonists - therapeutic use; Airway management; Biological and medical sciences; BODE; Body mass index; Bronchodilator Agents - therapeutic use; Clinical trials; COPD; Exercise Therapy; Fluticasone propionate; Forecasting; Glucocorticoids - therapeutic use; Hospitals; Humans; Hyperinflation; International COPD genetics network; Lung - physiopathology; Medical sciences; Miscellaneous; Mortality; Muscle, Skeletal - physiopathology; Nutritional Status; Oxidative stress; Pneumology; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Pulmonary rehabilitation; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Randomized Controlled Trials as Topic; Rehabilitation; Salmeterol; Systemic inflammation; Tiotropium; TORCH; UPLIFT; ATS; Oxidative stress; Salmeterol; LVRS; TLC; Pulmonary rehabilitation; MTCSA; Fluticasone propionate; International COPD genetics network; UPLIFT; TNF- α; BODE; Tiotropium; FEV 1; MMRC; TORCH; IC; Systemic inflammation; COPD; BMI; Lung; Inflammation; Systemic; Fluticasone; Chronic; Rehabilitation(human); Genetics; Disseminated; Rehabilitation; International
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2005.09.014

The pathophysiology of chronic obstructive pulmonary disease (COPD) is complex. The development of a multidimensional index—such as the BODE index—provides a means of classifying patients with COPD that also correlates with their prognosis. The individual components of the BODE index—body mass index (B), airflow obstruction (O) dyspnoea (D) and exercise capacity (E)—incorporate the pulmonary as well as the systemic effects seen in patients with COPD. Recent research has focussed on examining these impairments (including those of metabolism and inflammation) more carefully, and determining the effects of treatment on both the systemic and physiological aspects of COPD. Ongoing research initiatives by the public and private sector will contribute to our understanding of the disease processes underlying COPD, our understanding of the benefits associated with commonly used pharmacotherapies, as well as laying the foundations for the development of new agents and therapeutic tools. Advances in the use of pharmacotherapy have been mirrored by research to better define the benefits associated with pulmonary rehabilitation. Many questions remain to be answered, but a comprehensive approach is now considered essential to the life-long management of COPD, and will undoubtedly reduce the considerable socio-economic burden of COPD.