[Chronic obstructive pulmonary disease at the turn of the millennium]

The article reviews information on the chronic obstructive pulmonary disease (COPD), from the domestic and international sources. Significance of the disease has recently increased, in the US it becomes the fourth most frequent cause of death. Pathogenesis of the disease is different from the bronchial asthma, though in about 10% of patients both diseases can occur simultaneously. The article brings basic pathological and pathophysiological differences between both types of disease and it describes results of functional tests in relation to the most common international standards of the diagnostics and treatment of COPD. The most recent definition of COPD, elaborated by specialists associated in the Global initiative for COPD (= GOLD), stresses the abnormal reaction to the chronic inhalation of particles. Reviewed are also mechanisms of the effect of modern bronchodilatators--long acting beta 2-agonists, permanently conflicting views on the use of corticosteroids, and on the surgical treatment of COPD. Promising method appears the treatment with long-lasting anticholinergic drugs or the attempt to affect mediator antagonist be e.g. leucotrien D4 (LTD4) and the use inhibitors of phosphodiesterase 4.