Cited by 1,370Chronic Obstructive Pulmonary Disease (COPD) ResearchAsthma and respiratory diseasesCystic Fibrosis Research Advances

COPD exacerbations: Defining their cause and prevention

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Wedzicha, Jadwiga A, Seemungal, Terence AR·2007·The Lancet

Abstract

Exacerbations of chronic obstructive pulmonary disease (COPD) are episodes of worsening of symptoms, leading to substantial morbidity and mortality. COPD exacerbations are associated with increased airway and systemic inflammation and physiological changes, especially the development of hyperinflation. They are triggered mainly by respiratory viruses and bacteria, which infect the lower airway and increase airway inflammation. Some patients are particularly susceptible to exacerbations, and show worse health status and faster disease progression than those who have infrequent exacerbations. Several pharmacological interventions are effective for the reduction of exacerbation frequency and severity in COPD such as inhaled steroids, long-acting bronchodilators, and their combinations. Non-pharmacological therapies such as pulmonary rehabilitation, self-management, and home ventilatory support are becoming increasingly important, but still need to be studied in controlled trials. The future of exacerbation prevention is in assessment of optimum combinations of pharmacological and non-pharmacological therapies that will result in improvement of health status, and reduction of hospital admission and mortality associated with COPD.

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Crossref · 10.1016/s0140-6736(07)61382-8

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  • COPD is considered a lifestyle-related disease because long-term tobacco smoking and subsequent chronic bronchitis are causally associated with this disease.

    “COPD is considered to be a lifestyle-related disease, because long-term tobacco smoking and subsequent chronic bronchitis are causally associated with this disease [107].”

    From NO-Rich Diet for Lifestyle-Related Diseases (2015) · cites this paper as [107]

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Research works printed but not linked: 4

  1. [36]Sapey E Stockley RA COPD exacerbations. 2: Aetiology Thorax 61 2006 250 258 16517585 PMC2080749
  2. [62]Roberts CM Lowe D Bucknall CE Ryland I Kelly Y Pearson MG Clinical audit indicators of outcome following admission to hospital with acute exacerbation of chronic obstructive pulmonary disease Thorax 57 2002 137 141 11828043 PMC1746248
  3. [101]Powrie DJ, Wilkinson TMA, Donaldson GC, et al. Effect of tiotropium on inflammation and exacerbations in chronic obstructive pulmonary disease Eur Respir J (in press).
  4. [116]Garcia-Aymerich J Farrero E Félez MA Izquierdo J Marrades RM Antó JM for the Estudi del Factors de Risc d'Agudització de la MPOC investigators Risk factors of readmission to hospital for a COPD exacerbation: a prospective study Thorax 58 2003 100 105 12554887 PMC1746561

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Authors
Wedzicha, J. A., & Seemungal, T. A.
Affiliations
  • The Royal Free Hospital (GB)
  • University of the West Indies (TT)
Corresponding author
Wedzicha, Jadwiga A
Venue
The Lancet
Publisher
Elsevier BV
Published
2007-09
Volume
370
Issue
9589
Pages
786-796
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
OpenAlex
W2010967671
Cited by
1,370
References
130
Citations by year
2026: 99 · 2025: 100 · 2024: 93 · 2023: 74 · 2022: 75 · 2021: 84 · 2020: 100 · 2019: 75 · 2018: 74 · 2017: 58 · 2016: 48 · 2015: 59 · 2014: 60 · 2013: 41 · 2012: 50
FWCI
12.47
Type
journal article
Language
en
Open access
Locations
  • The Lancet (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
Keywords
COPD exacerbations, chronic obstructive pulmonary disease, exacerbation prevention, airway inflammation, hyperinflation, inhaled corticosteroids, long-acting bronchodilators, pulmonary rehabilitation, self-management, hospitalization, mortality
MeSH terms
Adrenal Cortex Hormones, Bacterial Infections, Bronchodilator Agents, Hospitalization, Humans, Phosphodiesterase Inhibitors, Severity of Illness Index, Exercise, Randomized Controlled Trials as Topic, Pulmonary Disease, Chronic Obstructive

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