New Insights Into Emphysema Help to Better Define Its Pathophysiology

Stephen I. Rennard, MD

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In This Article

Introduction

Chronic obstructive pulmonary disease (COPD) is becoming increasingly recognized as the major pulmonary public health problem worldwide. The condition is defined broadly as "a disease state characterized by airflow limitation that is not fully reversible" by the recently published Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines.[1] The broad definition of COPD is well recognized to embrace several pathologic conditions, including mucus hypersecretion, small airways disease, and emphysema. A majority of therapeutic efforts have targeted airflow limitation and have used forced expiratory volume in 1 second (FEV1) as the key physiologic outcome parameter. The importance of assessing additional parameters of disease in COPD, however, is becoming increasingly recognized, as is the need to develop effective means for subclassification of patients suffering from this heterogeneous condition. At the recent 11th Annual Congress of the European Respiratory Society in Berlin, Germany, experts gathered to discuss this topic at the symposium "New Frontiers in Lung Emphysema," where speakers presented both new information and new understanding of older data relating to the structural and functional heterogeneity of emphysema.

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