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23 chronic obstructive pulmonary disease -- Britannica Online Encyclopedia

chronic obstructive pulmonary disease

Chronic obstructive pulmonary
disease (COPD) results from the
inhalation of noxious particles
that cause progressive lung
damage. COPD is characterized
by emphysema, in which holes
form in the walls of lung alveoli,
and by excessive mucus
production, which causes
symptoms of bronchitis.
associations, including muscle weakness and osteoporosis. Identifying and treating these
secondary problems via pulmonary rehabilitation (supervised exercise) and other methods may
improve the functional status of the lungs.
chronic obstructive pulmonary disease (COPD),
progressive respiratory disease characterized by the
combination of signs and symptoms of emphysema and
bronchitis. It is a common disease, affecting tens of
millions of people and causing significant numbers of
deaths globally. Sources of noxious particles that can
cause COPD include tobacco smoke, air pollution, and
the burning of certain fuels in poorly ventilated areas. In
rare cases COPD is caused by a genetic defect that
results in deficiency of an enzyme known as α1-
antitrypsin, which is necessary for the physiological
repair of lung tissue. Although primarily a lung disease,
it is increasingly recognized that COPD has secondary

COPD is distinguished pathologically by the destruction of lung tissue, which is replaced by

holes characteristic of emphysema, and by a tendency for excessive mucus production in the
airway, which gives rise to symptoms of bronchitis. These pathological characteristics are
realized physiologically as difficulty in exhaling (called flow limitation), which causes
increased lung volume and manifests as breathlessness. Other early symptoms of the condition
include a “smokers cough” and daily sputum production. Coughing up blood is not a feature of
COPD and when present raises concern about a second, tobacco-related condition, particularly
lung cancer. Patients with COPD are vulnerable to episodic worsening of their condition
(called exacerbation). Exacerbations are triggered by infection, either bacterial or viral.
Therefore, antibiotics, which work against bacteria, are not always required. Frequent
exacerbations, particularly if severe enough to warrant hospital admission, indicate a poor
prognosis.

The only therapeutic intervention shown to alter the course of COPD is removal of the
noxious trigger, which can be accomplished in most cases by cessation of smoking.

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19/05/23, 18.23 chronic obstructive pulmonary disease -- Britannica Online Encyclopedia

Treatments used in the early stages of disease include vaccination against influenza and
pneumococcal pneumonia and administration of drugs that widen the airways (i.e.,
bronchodilators). Inhaled corticosteroids are commonly prescribed, especially for patients with
frequent exacerbations. Short courses (typically five days) of oral corticosteroids are given for
exacerbations but generally are not used in the routine management of COPD. A six–eight-
week course of pulmonary rehabilitation often benefits patients who have symptoms despite
inhaler therapy. This should be followed by a community/home maintenance program or by
repeat courses every two years.

In COPD patients with low blood-oxygen levels, the prescription of home oxygen can reduce
hospital admission and extend survival but does not alter the progression of lung disease.
Some COPD patients do not find oxygen attractive, since they need to use it for 16 hours each
day to derive benefit, which leads to further difficulties in mobility. In addition, oxygen is
extremely flammable, and the prescription of oxygen for patients who smoke remains
controversial because of the risk for explosion. Specialized centres can offer treatments for
patients with advanced disease, including noninvasive ventilation and surgical options (i.e.,
lung transplantation and lung-volume reduction).
Michael Polkey

Citation Information
Article Title: chronic obstructive pulmonary disease
Website Name: Encyclopaedia Britannica
Publisher: Encyclopaedia Britannica, Inc.
Date Published: 08 May 2023
URL: https://www.britannica.comhttps://www.britannica.com/science/chronic-obstructive-pulmonary-disease
Access Date: May 19, 2023

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