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Chronic Obstructive Pulmonary Disease (COPD): Causes, Symptoms, Modern Treatments, and the Future of Combating the Disease

Updated: Jul 10


Introduction: What Is COPD?

Chronic Obstructive Pulmonary Disease (COPD) is a progressive, long-term lung condition characterized by irreversible limitation of airflow to and from the lungs. This breathing disorder results in persistent respiratory symptoms such as shortness of breath, chronic cough, and production of sputum. According to the World Health Organization (WHO) and the latest Global Initiative for Chronic Obstructive Lung Disease (GOLD 2025) report, COPD is defined as a “heterogeneous lung condition caused by airway (bronchitis, bronchiolitis) and/or alveolar (emphysema) abnormalities, resulting in persistent and often progressive airflow obstruction.” Globally, it is among the leading causes of illness and death, particularly common in people over the age of 40, yet it often remains undiagnosed for many years.


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Causes and Risk Factors: Beyond Smoking 

Smoking remains the leading risk factor for developing COPD, but modern scientific data shows that not all patients are smokers—1 in 4 individuals with COPD have never smoked. The disease arises from a complex interplay between genetic predisposition, environmental exposures, and temporal factors—a concept summarized as “GETomics” (Genetics, Environment, Time). The main risk factors include:

  • Active and passive smoking

  • Exposure to dust, chemicals, and fumes at the workplace

  • Indoor air pollution—such as heating and cooking with wood or biomass

  • Outdoor pollution and climate change—polluted air, ozone, and particulate matter

  • Frequent respiratory infections and poor lung development during childhood

  • Genetic factors—such as alpha-1 antitrypsin deficiency (a rare but important cause)

  • Age and socioeconomic factors—higher risk for older adults, women, low-income individuals, and rural populations



Main Symptoms: How Does COPD Present Itself? 

The disease features characteristic chronic respiratory symptoms and periodic flare-ups (exacerbations):

  • Shortness of breath (especially during physical activity, and in advanced stages, even at rest)

  • Chronic cough—often with sputum that may be clear, white, yellow, or greenish

  • Wheezing or whistling sounds when breathing

  • Fatigue, weakness, and reduced physical capacity

  • Frequent respiratory infections (e.g., flu, pneumonia)

  • Chest tightness

  • Acute exacerbations—sudden worsening of symptoms often requiring medical attention and potentially hospitalization

As the disease progresses, even daily activities become increasingly difficult, and quality of life decreases significantly.



Diagnosis: How Is COPD Diagnosed? 

The gold standard for diagnosis is spirometry—an objective lung function test. The diagnosis is confirmed when the FEV₁/FVC ratio (forced expiratory volume in 1 second/forced vital capacity) is below 0.7 after administration of a bronchodilator. Additional diagnostic steps include:

  • Detailed medical history—exposure to risk factors, symptom descriptions, frequency of exacerbations

  • Physical examination—auscultation, visual inspection, oxygen saturation testing

  • Imaging studies (X-ray, CT scan)—not required for diagnosis but used to rule out other conditions or assess complications

  • Assessment questionnaires—mMRC (Modified Medical Research Council Dyspnea Scale), CAT (COPD Assessment Test), SGRQ (St. George’s Respiratory Questionnaire) to evaluate symptom severity and impact on quality of life

  • Repeat spirometry—recommended when results are borderline to confirm the diagnosis



Modern Treatment Guidelines: A Multidisciplinary and Personalized Approach 

COPD treatment is based on individualized care plans that consider the severity of the disease, symptoms, frequency of exacerbations, and presence of other health conditions.


1. Smoking Cessation The most important step—scientifically proven to slow disease progression.

2. Pharmacotherapy

  • Bronchodilators (long-acting β2-agonists and/or anticholinergics, LABA/LAMA)—the cornerstone of treatment to relieve symptoms and improve quality of life

  • Inhaled corticosteroids (ICS)—used for frequent exacerbations and/or presence of blood eosinophilia (a biomarker for better response to ICS)

  • Triple therapy (LABA + LAMA + ICS)—for patients with severe symptoms or frequent exacerbations, especially when eosinophil count is ≥ 300 cells/μL

  • New therapies—such as ensifentrine and dupilumab, are increasingly used according to recent clinical trials

3. Non-Pharmacological Interventions

  • Pulmonary rehabilitation—includes exercise training, dietary counseling, and psychological support

  • Vaccinations—against influenza, pneumococcal disease, and COVID-19

  • Long-term oxygen therapy—for patients with chronic hypoxemia

  • Targeted treatment of comorbidities—especially cardiovascular diseases and pulmonary hypertension

4. Self-Monitoring and Digital Technologies New mobile apps and digital inhalers allow monitoring of medication use and inhalation technique, as well as early detection of exacerbations.



Recent Scientific Discoveries and Future Outlook In recent years, the scientific community has made several important advancements:

  • Artificial intelligence—used to analyze chest X-rays and predict COPD survival outcomes

  • Biomarkers for personalized treatment—such as blood eosinophils to guide ICS therapy

  • Real-world implementation of guidelines—clinical practices often lag behind official recommendations, highlighting the need for ongoing education and oversight

  • Impact of climate change and pollution—environmental factors are increasingly recognized as contributors and aggravators of COPD

  • Reclassification of COPD as a systemic inflammatory disease—with a focus on cardiovascular complications and a holistic treatment approach



Conclusion: What Does This Mean for Patients? COPD is no longer viewed solely as a smoker’s disease but as the result of complex interactions between genetics, the environment, and time. Early diagnosis, personalized care, and strict adherence to modern therapeutic guidelines significantly improve patient outcomes and quality of life. Full integration of new medications, digital tools, and careful management of comorbidities will be crucial to the future of COPD treatment.



Key References Used:

GOLD 2025 Global Strategy for the Diagnosis, Management, and Prevention of COPD (official report)

WHO: Fact sheet on Chronic Obstructive Pulmonary Disease (COPD)https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)

CDC: About COPDhttps://www.cdc.gov/copd/about/index.html

Radiology: Deep Learning Models for Survival Predictionhttp://pubs.rsna.org/doi/10.1148/radiol.212071

Nature: COPD Genetics and Environmenthttps://www.nature.com/articles/s41533-023-00349-4


Clinical Trials Referenced:


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