In the four decades I’ve devoted to lung health, chronic obstructive pulmonary disease has been slow to excite the practicing physician. Yet COPD should create great enthusiasm because we have made so many advances in identification and treatment. Many new therapies are available that are effective and favorably influence the disease.
COPD is associated with numerous co-morbidities, and indeed, the entire body may become involved.1It is now regarded as a systemic disease.2Traditionally, COPD has included emphysema (loss of alveolar walls and loss of elastic recoil), chronic bronchitis, inflammation in the small and large airways, and various degrees of lung inflammation throughout the lung parenchyma.
More recently, bronchiectasis has been added to this spectrum, although there are significant differences in manifestations and pathogenesis with repeated bacterial infections playing a more prominent role in bronchiectasis than with emphysema and chronic bronchitis.