COPD exacerbations: Defining their cause and prevention
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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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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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- 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
- PMC
- PMC7134993
- 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
- bronze
- doi.org
- 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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