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., 3-Dec-2019, In : JOURNAL OF PATHOLOGY. 250, 5, p. 624-635 12 p.

Research output: Contribution to journalReview articleAcademicpeer-review

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. Together with smoking cessation, current treatment strategies of COPD aim to improve symptoms and prevent exacerbations, but there is no disease-modifying treatment. The biggest drawback of today's COPD treatment regimen 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, ECM and age-related changes, structural changes in the small airways and the role of sex-related differences, which are all relevant to explain the individual differences in the 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. (c) 2019 Authors. Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

Original languageEnglish
Pages (from-to)624-635
Number of pages12
Issue number5
Early online date5-Nov-2019
Publication statusPublished - 3-Dec-2019


  • COPD, inflammation, aging, ECM, genome-wide association study, CELSR1, sex differences, small airways, precision imaging, personalized treatment, biologics, SMALL-AIRWAY OBSTRUCTION, INNATE LYMPHOID-CELLS, EXTRACELLULAR-MATRIX, LUNG-FUNCTION, COMPUTED-TOMOGRAPHY, SEX-DIFFERENCES, GENDER-DIFFERENCES, SMOKING-CESSATION, ELASTIC FIBERS, SEVERE COPD

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