CODP - Chronic Obstructive Pulmonary Disease

  • Condition

Chronic Obstructive Pulmonary Disease or COPD, a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases.1 COPD includes chronic bronchitis and emphysema and basically is a chronic lung disease that makes it hard to breathe.2,3
According to the latest WHO estimates (2004), currently 64 million people have COPD and 3 million people died of COPD. Is the fifth leading cause of death and WHO predicts that COPD will become the third leading cause of death worldwide by 2030.4
Risk factors for COPD are:1,2,5

  • exposure to particles
    • smoke *
    • occupational dusts organic and inorganic
    • indoor air pollution
    • outdoor air pollution
  • Genes (alpha-1 antitrypsine deficiency)
  • Lung growth and development
  • Gender
  • Age
  • Respiratory infections
  • Socioeconomic status
  • Asthma/Bronchial hyperreactivity and Chronic Bronchitis1,2,5

The mechanisms that lead to airflow limitation are small airway disease (airway inflammation, airway fibrosis, luminal plugs, increased airway resistance) and parenchymal destruction (loss of alveolar attachments, decrease of elastic recoil)1.
The diagnosis of COPD is done by having symptoms of shortness of breath, chronic cough and sputum with a history of risk factors1,4and with a Spirometry1,2,3,4,6. A post-bronchodilator FEV1/FVC < 0.70 confirms the presence of airflow limitation and thus COPD.1
For the treatment we have to consider that an effective COPD management plan includes four components: Assess and monitor disease, reduce risk factors, manage stable COPD and manage exacerbations.4Smoking cessation has the greatest capacity to influence the natural history of COPD. Patients benefit from regular physical activity. Appropiate pharmacologic therapy can reduce symptoms, reduce de frequency and severity and exercise tolerance.
None of the existing medications has been shown conclusively to modify the long-term decline in lung function*.1
Transplantation of MSCs represents a potentially promising therapy for COPD, and involve modulation of inflammation, protease/antiprotease balance, apoptosis and oxidative stress, or the differentiaton of MSCs into lung parenchyma cells.7,8,9

The material that you just read comes from the following links.

References

  1. Global initiative for chronic Obstructive Lung Disease (GOLD); Global Strategy for Diagnosis Management and Prevention of COPD; updated jan 2015; www.goldcopd.org
  2. National Heart Lung and Blood Institute http://www.nhlbi.nih.gov/health/health-topics/topics/copd
  3. http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/?referrer=https://www.google.com.mx/
  4. World Health Organization (WHO) www.who.int
  5. Mannino, David M et al. Global burden of COPD: risk factors, prevalence, and future trends; The Lancet Volume 370, Issue 9589, pg 765-773.
  6. Ramirez-Venegas CA, et al. Guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease Derived from the Fourth Mexican Consensus on the Diagnosis and Treatment of COPD; Neumol Cir Torax 2012; 71(S1):8-89; available in: http://goo.gl/KE1Be5
  7. ZhixianJin, et al. Biological effects and mechanisms of action of mesenchymal stem cell therapy in chronic obstructive pulmonary disease; J Int Med Res 2015; 43(3):303-310
  8. Alkhouri H, Poppinga WJ, Tania NP, Ammit A, Shulinga M; Regulation of pulmonary inflammation by mesenchymal cells; PulmpharmacolTher 2014; 29(2): 156-165.
  9. Akram KM, Patel N, Spiteri MA, Forsyth NR. Lung regeneration: Endogenos and Exogenous Stem Cell Mediated Therapeutic Aproaches. Int J MolSci 2016; 19, 17(1)

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