[Toward personalized and integrated treatment of patients with COPD]

The concept of chronic obstructive pulmonary disease (COPD) is broad and generic. In clinical practice and research, the definition of COPD is based on the extent of airflow obstruction measured through spirometry. However, it is currently known that this disease encompasses a complex variety of cellular, anatomical, functional and clinical manifestations that could allow distinct COPD phenotypes to be defined. Moreover, the severity of COPD depends not only on pulmonary function evaluated through spirometry but also on other variables such as clinical symptoms, exacerbations and the presence of complications and comorbidities, which contribute to distinguishing among the distinct phenotypes. Phenotypic heterogeneity may affect treatment response and the clinical course of the disease. COPD is, therefore, a complex entity requiring comprehensive and multidimensional evaluation to establish more personalized and integrated treatment.