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Pre-chronic obstructive pulmonary disease: a pathophysiologic process or an opinion term?
Takudzwa Mkorombindo1, Mark T Dransfield
1Lung Health Center, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Smokers without airflow limitation may have significant lung issues and respiratory symptoms. Identifying this "pre-COPD" group could enable earlier interventions for better outcomes.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Public Health
Background:
- Current chronic obstructive pulmonary disease (COPD) guidelines often exclude smokers without spirometric airflow limitation.
- Significant lung pathology and respiratory impairment can exist in exposed individuals even without airflow limitation detected by spirometry.
Purpose of the Study:
- To review the respiratory morbidity burden in smokers without airflow limitation.
- To discuss the potential utility of classifying this group as "pre-COPD" for targeted interventions.
Main Methods:
- Literature review of current guidelines and research on respiratory morbidity in smokers.
- Analysis of the diagnostic limitations of spirometry in detecting early lung pathology.
Main Results:
- Many individuals with smoking history experience substantial respiratory morbidity despite normal spirometry.
- This
- pre-COPD
- population may have a prognosis comparable to those with diagnosed COPD.
Conclusions:
- Spirometry may not be sensitive enough to identify all individuals with lung pathology and symptoms.
- Early identification of the
- pre-COPD
- population could lead to more effective, disease-modifying treatments and preventive strategies.
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