COPD Exacerbation Syndrome: The Spanish Perspective on an Old Dilemma

The definition of exacerbation of COPD as a syndrome, as proposed by the Spanish COPD guidelines (GesEPOC) 2021 update, and the consequences that this implies, have direct implications on patient care. This review analyzes this novel vision of the COPD exacerbation syndrome, its rationale, and its c...

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Detalles Bibliográficos
Autores: Soler-Cataluña, Juan José, López-Campos Bodineau, José Luis
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/146457
Acceso en línea:https://hdl.handle.net/11441/146457
https://doi.org/10.2147/COPD.S393535
Access Level:acceso abierto
Palabra clave:COPD
exacerbations
syndrome
guideline
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spelling COPD Exacerbation Syndrome: The Spanish Perspective on an Old DilemmaSoler-Cataluña, Juan JoséLópez-Campos Bodineau, José LuisCOPDexacerbationssyndromeguidelineThe definition of exacerbation of COPD as a syndrome, as proposed by the Spanish COPD guidelines (GesEPOC) 2021 update, and the consequences that this implies, have direct implications on patient care. This review analyzes this novel vision of the COPD exacerbation syndrome, its rationale, and its clinical implications, as opposed to the traditional symptoms-based or event-based definitions. An exacerbation conceived as a syndrome provides us with an umbrella term to include a set of diverse alterations, which, either in isolation or more frequently in combination, are clinically expressed in a similar way in patients with COPD. In patients with COPD, this occurs as a consequence of worsening expiratory airflow limitation or the underlying inflammatory process, producing a worsening in symptoms with respect to the baseline situation. This definition therefore assumes a worsening in at least one of the two key physiopathological markers, lung function and inflammation. The main features of this new physiopathological proposal include a syndromic approach with narrower differential diagnosis, the use of several biomarkers, treatable traits to better guide treatment, and a new severity classification. Further research is needed to examine the role of eosinophils in this context, but currently, the early results are promising. The evaluation of severity is key in the multidimensional characterization of exacerbation and the GesEPOC 2021 proposes new approaches and also recommends the use of multidisciplinary scores for severity categorization in patients. Finally, another innovation in the GesEPOC 2021 refers to the recurrence of exacerbations, which has implications for disease prognosis or long-term clinical impact which need to be elucidated in further studies.Taylor and Francis GroupMedicina2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/146457https://doi.org/10.2147/COPD.S393535reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésInternational Journal of Chronic Obstructive Pulmonary Disease, 17, 3139-3149.https://www.dovepress.com/copd-exacerbation-syndrome-the-spanish-perspective-on-an-old-dilemma-peer-reviewed-fulltext-article-COPDinfo:eu-repo/semantics/openAccessoai:idus.us.es:11441/1464572026-06-17T12:51:07Z
dc.title.none.fl_str_mv COPD Exacerbation Syndrome: The Spanish Perspective on an Old Dilemma
title COPD Exacerbation Syndrome: The Spanish Perspective on an Old Dilemma
spellingShingle COPD Exacerbation Syndrome: The Spanish Perspective on an Old Dilemma
Soler-Cataluña, Juan José
COPD
exacerbations
syndrome
guideline
title_short COPD Exacerbation Syndrome: The Spanish Perspective on an Old Dilemma
title_full COPD Exacerbation Syndrome: The Spanish Perspective on an Old Dilemma
title_fullStr COPD Exacerbation Syndrome: The Spanish Perspective on an Old Dilemma
title_full_unstemmed COPD Exacerbation Syndrome: The Spanish Perspective on an Old Dilemma
title_sort COPD Exacerbation Syndrome: The Spanish Perspective on an Old Dilemma
dc.creator.none.fl_str_mv Soler-Cataluña, Juan José
López-Campos Bodineau, José Luis
author Soler-Cataluña, Juan José
author_facet Soler-Cataluña, Juan José
López-Campos Bodineau, José Luis
author_role author
author2 López-Campos Bodineau, José Luis
author2_role author
dc.contributor.none.fl_str_mv Medicina
dc.subject.none.fl_str_mv COPD
exacerbations
syndrome
guideline
topic COPD
exacerbations
syndrome
guideline
description The definition of exacerbation of COPD as a syndrome, as proposed by the Spanish COPD guidelines (GesEPOC) 2021 update, and the consequences that this implies, have direct implications on patient care. This review analyzes this novel vision of the COPD exacerbation syndrome, its rationale, and its clinical implications, as opposed to the traditional symptoms-based or event-based definitions. An exacerbation conceived as a syndrome provides us with an umbrella term to include a set of diverse alterations, which, either in isolation or more frequently in combination, are clinically expressed in a similar way in patients with COPD. In patients with COPD, this occurs as a consequence of worsening expiratory airflow limitation or the underlying inflammatory process, producing a worsening in symptoms with respect to the baseline situation. This definition therefore assumes a worsening in at least one of the two key physiopathological markers, lung function and inflammation. The main features of this new physiopathological proposal include a syndromic approach with narrower differential diagnosis, the use of several biomarkers, treatable traits to better guide treatment, and a new severity classification. Further research is needed to examine the role of eosinophils in this context, but currently, the early results are promising. The evaluation of severity is key in the multidimensional characterization of exacerbation and the GesEPOC 2021 proposes new approaches and also recommends the use of multidisciplinary scores for severity categorization in patients. Finally, another innovation in the GesEPOC 2021 refers to the recurrence of exacerbations, which has implications for disease prognosis or long-term clinical impact which need to be elucidated in further studies.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/146457
https://doi.org/10.2147/COPD.S393535
url https://hdl.handle.net/11441/146457
https://doi.org/10.2147/COPD.S393535
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International Journal of Chronic Obstructive Pulmonary Disease, 17, 3139-3149.
https://www.dovepress.com/copd-exacerbation-syndrome-the-spanish-perspective-on-an-old-dilemma-peer-reviewed-fulltext-article-COPD
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Taylor and Francis Group
publisher.none.fl_str_mv Taylor and Francis Group
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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