Researchers Propose New Definition of COPD

While smoking plays a key pathogenic role in chronic obstructive pulmonary disease (COPD), other factors play a role as well, according to the authors of the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report.

To better reflect the varied contributors to COPD, the report proposes a new definition of COPD.

The GOLD 2023 report defines COPD as “a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, expectoration, exacerbations) due to abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that cause persistent, often progressive, airflow obstruction.”

“The updated definition focuses on patient characteristics that then allows us to go into etiology and diagnostic criteria in more detail separately,” said MeiLan Han, chief of pulmonary and critical care medicine at the University of Michigan and a co-author of the GOLD 2023 report, in a statement. “This is important because we now can better emphasize all of the factors that can contribute to COPD beyond tobacco exposure.”

In low-income and middle-income countries, which contribute to over 85 percent of all COPD cases worldwide, “nonsmoking COPD may be responsible for up to 60 [percent] to 70 percent of cases,” noted the report’s authors. Other risk factors, they said, include environmental factors, such as indoor and outdoor air pollution; lung development and aging; socioeconomic status; asthma and airway hyper-reactivity; and infections.