[Annual progress in chronic obstructive pulmonary disease 2025]

Chronic obstructive pulmonary disease (COPD), as the third leading cause of death globally, continues to impose a growing disease burden and has become a major public health challenge. Over the past year, breakthrough progress has been made in the field of precision diagnosis and treatment. In screening and diagnosis, a multi-tiered screening system based on healthcare resource stratification has established a comprehensive pathway from questionnaire-based initial screening to simplified pulmonary function tests and artificial intelligence-assisted CT analysis. The innovative development of multidimensional diagnostic criteria has overcome the limitations of traditional pulmonary function assessments, significantly improving the accuracy of identifying high-risk individuals at an early stage. In disease mechanism research, from the establishment of pre-COPD warning indicators to the mechanistic analysis of various clinical phenotypes, systematic studies have elucidated the initiating role of small airway dysfunction, the heterogeneous characteristics of mild-to-moderate COPD, the dynamic evolution patterns of mucus plugs, and the molecular basis of emphysema phenotypes. In the therapeutic domain, biologics targeting type 2 inflammation (e.g., dupilumab, mepolizumab) have demonstrated remarkable efficacy in patients with eosinophilic phenotypes, providing new options for advancing phenotype-based individualized treatment strategies. These groundbreaking advances collectively establish a new paradigm for precision diagnosis and treatment of COPD, marking the formal transition of disease management into a comprehensive process spanning from early warning to precision intervention.