Although it is known that individuals who smoke cigarettes are at risk of developing lung diseases and of dying earlier, most people who smoked 20 cigarettes a day for over 50 years or longer do not develop lung disease. Identifying those who develop disease at an early age would help health providers to intervene earlier and reduce the long-term suffering of these individuals.

Our study calculated the lung function of heavy smokers by measuring the amount of air a person can breathe out in one second. We continued to measure lung function in these individuals over an average of 17 years. From the 100 individuals who participated in this study, those with a high lung function at the beginning of the study continued to have higher lung function than those who had low lung function from the start of the study. A detailed review of the overall health of these individuals showed that those with low compared with high lung function developed more diseases of the lungs, heart, and kidneys and died earlier.

This study shows that simply measuring the lung function of teenagers who start smoking may help identify individuals who will need more focused attention to avoid future health problems.

This study compared 2 different ways of measuring a type of white blood cell (eosinophils) that plays a role in inflammation in people with chronic obstructive pulmonary disease (COPD). Eosinophillic inflammation (when too many eosinophil white blood cells accumulate and cause damage) has been identified in many patients with COPD but studies of these patients have confusing results. This study compared measurements of eosinophils in both the blood and the sputum (mucus or phlegm coughed up from the lungs).

In this study, samples from both blood and sputum tests were taken at 2 different visits from 107 individuals with COPD. Blood tests were easier to get and were more reliable over time. However, blood tests and sputum tests often gave different results, and they did not identify the same people as having high levels of eosinophils. As well, people with higher levels of eosinophils in the sputum tended to have more severe COPD.

This study suggests that both blood and sputum eosinophil tests can provide useful information, but they do not always agree. More work is needed to understand how best to use these tests to identify people with a specific type of inflammation in COPD. Better testing could help doctors provide more targeted treatments for people with COPD in the future.

Previous research found a link between a group of proteins called cathepsins and chronic obstructive pulmonary disease (COPD). However, these studies could not determine if cathepsins actually cause the disease.

This new study used genetic information to look at this cause-and-effect relationship more clearly. We reviewed data to see if people at risk of having higher levels of certain cathepsins were also more likely to develop COPD. Nine different types of proteins were examined individually. A significant direct link was not found. However, when the nine cathepsin types and their interactions were studied together, 2 specific types, cathepsin O and S, were found to be independent risk factors, meaning they can increase an individual’s risk of developing COPD. This was true even after accounting for an individual’s smoking history This study identifies cathepsins O and S as possible links to COPD that could be important focuses of future drug development, but more research is needed to confirm these findings.

Chronic obstructive pulmonary disease (COPD) is a lung condition that makes breathing difficult and tends to get worse over time. While asthma management includes the idea of “disease control,” this is not widely used in COPD. A group of Spanish researchers developed a tool to measure whether a person’s COPD is well controlled, based on symptoms and how stable (not getting worse) their disease is over time.

We tested this tool with 133 patients in a Portuguese hospital for one year. At each visit, we evaluated whether their disease was controlled. About one-third were considered controlled at any given time, but only 12% stayed controlled throughout the year. Patients who were not controlled were more likely to need emergency care, especially after one year.

The tool was easy to apply in routine care and helped doctors understand patients’ overall health. However, in our group—mostly made up of people with severe COPD—it did not clearly predict future flare-ups. Other studies suggest that the tool may be more useful in patients with milder disease, where being “controlled” seems to be linked to fewer symptoms and fewer health problems. More research is needed to confirm this and guide care for different COPD patients.

Chronic lung diseases can affect men and women differently, but we do not fully understand these differences. To learn more, we surveyed over 600 people living with chronic obstructive pulmonary disease (COPD), bronchiectasis, or a related lung infection called nontuberculous mycobacteria (NTM), to better understand their symptoms and experiences with diagnosis and treatment.

Most participants were women, and the majority had COPD. We found that women with COPD sought medical care sooner after symptoms started compared to men but were less likely to have their diagnosis clearly explained by a doctor. They also reported more anxiety and fear related to their diagnosis. Among those with bronchiectasis, men were more likely to receive a confirmed diagnosis sooner, often while hospitalized.

These findings show the importance of understanding how men and women experience chronic lung disease differently. Understanding these patterns can help health care providers improve communication with patients and provide better, more personalized care for everyone with chronic lung conditions.

Chronic obstructive pulmonary disease (COPD) is a lung condition that often goes undiagnosed, especially in people who do not show obvious symptoms. Because routine screening is not recommended for everyone, doctors use tools to help identify people who might have COPD. One such tool is called CAPTURE, which includes a short questionnaire and a breathing test. In this study, we wanted to see if CAPTURE works better in people who are already being screened for lung cancer, since they tend to have a history of smoking and are more likely to have COPD.

We asked 67 people in a lung cancer screening program to complete the CAPTURE questionnaire and take a breathing test. We also looked at their chest scans. About 1 in 4 participants had COPD. We found that combining the questionnaire with either the breathing test or signs of emphysema on their scan helped identify COPD more accurately than using the questionnaire alone.

This research shows that CAPTURE can be a useful tool in lung cancer screening programs to catch COPD early. In the future, this could help doctors treat patients sooner and improve their quality of life.

People living in rural areas with chronic obstructive pulmonary disease (COPD) often have worse health results than individuals with COPD in cities. More effective ways are needed to deliver proven treatments and design studies that include rural communities. In this statement, the COPD Foundation’s Medical and Scientific Advisory Committee outlines major challenges and possible solutions.

Rural residents face unique barriers, including long distances to care, fewer specialists, limited internet access, and complex smoking or environmental exposure histories. These issues are not fully captured by typical definitions of “rural,” making it harder to understand and address the health needs of these communities.

To improve research and care for rural residents with COPD, we recommend collecting better data on travel time to care and social factors, using more flexible research methods like interviews and mixed methods approaches, and creating partnerships that support primary care clinics. Locally-focused ways of recruiting research participants, such as using community partners supported by pulmonary specialists and traveling clinics, should be considered when designing studies for this population. These strategies will help researchers and providers better understand and address the reasons behind poor health outcomes for people with COPD living in rural areas.

Chronic obstructive pulmonary disease (COPD) impacts patients' daily lives. This study explored how people with COPD describe their symptoms and daily struggles. Researchers evaluated 19 previously published studies where people with COPD shared their experiences through interviews, group discussions, or online forums.

In these studies, people talked about struggling to breathe, coughing, dealing with mucus and wheezing, feeling tired and weak, difficulty sleeping, and chest discomfort. They also shared how these symptoms can make tasks—like walking, climbing stairs, or getting dressed—hard to manage. Individuals with COPD explained that their physical struggle with COPD affects their emotional and social lives, leading to feelings of frustration, isolation, and sadness.

Bringing together patient views and experiences from multiple studies creates an overview of what life with COPD is like. It also highlights research gaps and opportunities such as understanding COPD symptoms by age, gender, or stage of illness.

These findings provide a starting point to guide conversations with patients and researchers about topics to be addressed in future research. Involving patients in deciding which patient results to track will help ensure new treatments address real-world concerns and improve quality of life.

Patients with chronic obstructive pulmonary disease (COPD) are at a high risk of taking several drugs—called polypharmacy— and having adverse drug reactions. There are many different definitions of polypharmacy being used in research studies. We conducted a review to collect and combine knowledge on polypharmacy in COPD and identified 28 previously published articles to include.

In our review, we found that polypharmacy in COPD is poorly understood and described. There was no consistent definition of polypharmacy across these papers, and the majority of studies defined polypharmacy as the use of 5 or more medications. The studies suggested a polypharmacy rate ranging from 3.9% to 81.4% and this large range likely reflected the different patient populations, settings, and the use of different definitions. The most common features of individuals with COPD experiencing polypharmacy were being older, having more than one medical problem, and being a smoker. In addition, we saw that polypharmacy and having more than one medical problem or comorbidities, contributed to individuals not taking their medications consistently, and as prescribed.

Future studies with a clear definition of polypharmacy and a focus on what factors may predict polypharmacy are needed. Finally, health care providers should be mindful of the patient’s age, comorbidities, and risks of drug interactions while prescribing medications for individuals with COPD.

When pulmonary function tests are completed on patients with respiratory symptoms, they are frequently done both before and after the patient has taken medicine using an inhaler. If there is a large enough improvement in the test results after the medicine has been inhaled, this is called a positive bronchodilator response.

A positive bronchodilator response can help distinguish between asthma, chronic obstructive pulmonary disease, and syndromes where both are present. The definition for a positive bronchodilator response was recently changed to remove race correction factors which previously considered some low lung function results in Black (and Asian) individuals as normal results, so many Black individuals were not correctly diagnosed with lung disease. Our study looked at the bronchodilator response in White and Black patients using both the old and new definitions.

Using the old definition, the frequency of positive bronchodilator responses was similar in White (52.2%) and Black (55.8%) patients. Using the new definition, White patients were more likely than Black patients (47.1% versus 36.9%) to have a positive bronchodilator response. We do not yet have a full understanding of the effects of this difference, but it is important for health care providers to be aware of it to avoid introducing gaps or inequalities into their diagnosis or care for patients with respiratory symptoms.