Five-year View
In a landmark meeting half a century ago, William Briscoe used the term COPD. Since then, the pathophysiology and treatment modalities of chronic bronchitis and emphysema filled the textbooks. Future perspectives rely on a targeted approach, with an evolving definition of COPD, better characterized by a coexistence of emphysema, small airway disease and interstitial fibrosis. And the prevalence of each of these components will determine the clinical impact and treatment. Promising biomarkers, such as fibrinogen, may determine which patient is at risk for associated co-morbidities. Emerging bronchodilators as the long-acting inhaled bifunctional muscarinic antagonist-β2 agonist, still under investigation, may add on the treatment arsenal. And should physicians use a more dramatic terminology to highlight the deleterious effect of exacerbations, a term like 'lung attack' may be considered.