Phenotypes of Exacerbations in Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with an important public health challenge and a major burden on health-care resources, having a progressive character with constant deterioration of lung function. During the course of the disease, patients experience acute episodes of exacerbation, which are characterized by worsening symptoms, and require additional treatment during these exacerbating episodes. Given the heterogeneity of exacerbations, their phenotyping is of great interest in order to administer the most effective treatment with the aim of reducing mortality and preventing future exacerbation episodes. The lack of specific biomarkers for the diagnosis of acute exacerbations of COPD maintains researchers' interest in trying to identify such a biomarker. In this review, we explore the different phenotypes of COPD exacerbation, and we also evaluated the ability of various biomarkers to establish the etiology of exacerbations in association with clinical manifestations. Furthermore, we addressed the main therapeutic measures necessary according to each phenotype. Overall, phenotyping exacerbations allows for an individualized approach to these patients, thus avoiding the side effects of some treatments.