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Recent advances in chronic obstructive pulmonary disease pathogenesis: from disease mechanisms to precision medicine

Brandsma, C-A., Van den Berge, M., Hackett, T-L., Brusselle, G. & Timens, W., 5-Nov-2019, In : JOURNAL OF PATHOLOGY.

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  • Recent advances in chronic obstructive pulmonary disease pathogenesis from disease mechanisms to precision medicine

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Chronic obstructive pulmonary disease (COPD) is a devastating lung disease with a high personal and societal burden. Exposure to toxic particles and gases, including cigarette smoke, is the main risk factor for COPD. Next to smoking cessation, current treatment strategies of COPD aim to improve symptoms and prevent exacerbations, yet there is no disease modifying treatment. The biggest drawback of today's COPD treatment regime is the 'one size fits all' pharmacological intervention, mainly based on disease severity and symptoms and not the individual's disease pathology. To halt the worrying increase in the burden of COPD, disease management needs to be advanced with a focus on personalized treatment. The main pathological feature of COPD includes a chronic and abnormal inflammatory response within the lungs which results in airway and alveolar changes in the lung as reflected by (small) airways disease and emphysema. Here we discuss recent developments related to the abnormal inflammatory response, extracellular matrix and age-related changes, structural changes in the small airways, and the role of sex-related differences, that are all relevant to explain the individual differences in disease pathology of COPD and improve disease endotyping. Furthermore, we will discuss the most recent developments of new treatment strategies using biologicals to target specific pathological features or disease endotypes of COPD. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalJOURNAL OF PATHOLOGY
Publication statusE-pub ahead of print - 5-Nov-2019

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