Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, involving the health-care system at every level of care. Being a chronic disease, COPD patients need continuous care and monitoring throughout their life. However, because of frequent and severe respiratory exacerbations, require considerable resources of the critical area. Therefore, the management of these patients commit the healthcare system at all levels from emergency medicine to rehabilitation. The recent innovation in molecular biology, genomics, imaging techniques, pulmonary function testing, artificial intelligence, and their physio-pathological implication to the patient’s capacity and response to environmental have provided greater insight into disease pathobiology and pathophysiology which might result in advances in COPD prevention, diagnosis, treatment and prognosis. The identification of specific subpopulations using new biomarkers, radiological, or clinical based strategy, allowed the definition of specific clinical pathways and targeting therapies depending on patient’s characteristics. A great effort is still needed to integrate the various innovations coming from research and from different contexts, and translate them into effective clinical-therapeutic pathways for the patient.
In the last 5 years several mechanisms in the processes have been elucidated and there is a need to find an application in clinical practice. Different COPD phenotypes show different response to noxious exposure, different decline in lung function and exercise capacity, different impact in dyspnea on exertion and different susceptibilities to exacerbations. COPD pathogenesis is heterogenous with patients exhibiting airway disease, emphysema, inflammation, and vascular dysfunction to varying extents leading to the different phenotypes. The underling molecular, genetics and immune response are probably at the base of these differences and need different clinical approach that should be defined. The aim of this collection is to investigate how these differences can be translated into different clinical approaches in different clinical settings.
This collection intends to focus on the translation of new pathophysiological insight in clinical application in the different contexts: critical care, daily treatment, functional assessment, exertional dyspnea, rehabilitation, and artificial intelligence. We are particularly interested in the management and treatment of respiratory exacerbations and the progression of functional capacity decline in these patients. The definition of possible different approaches and intervention showing a significant impact on the patient's clinical history, are within the scope of this collection. Use of specific and innovative technic for the treatment of acute respiratory and ventilatory failure with a special interest on clinical phenotypes on different approach in the critical care setting. In the context of daily treatment and rehabilitation, this collection aims to investigate the effects of the various treatments in the various phenotypes of the disease, in order to optimize the benefit that the patient can derive from the treatment.
All types of articles are welcome, but the most innovative studies that open up to other lines of research will have particular relevance.
Disclosure statement: Prof. Laveneziana, Dr. Valli, and Dr. Palange have no conflicts of interest to
disclose regarding this work.
