The Open Respiratory Medicine Journal




ISSN: 1874-3064 ― Volume 14, 2020

Chronic Obstructive Airways Diseases: Where Are We Now?



Jordan Minov§, Saso Stoleski*, §
Center for Respiratory Functional Diagnostics, Institute for Occupational Health, WHO Collaborating Center and Ga2Len Collaborating Center, II Makedonska Brigada 43, 1000 Skopje, R. Macedonia


Article Information


Identifiers and Pagination:

Year: 2015
Volume: 9
Issue: Suppl 1: M1
First Page: 37
Last Page: 38
Publisher Id: TORMJ-9-37
DOI: 10.2174/1874306401509010037

Article History:

Electronic publication date: 31 /3/2015
Collection year: 2015

© Minov and Stoleski.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.


* Address correspondence to this author at the Center for Respiratory Functional Diagnostics, Institute for Occupational Health, WHO Collaborating Center and Ga2len Collaborating Center, II Makedonska Brigada 43, 1000 Skopje, R. Macedonia; Tel: +389 71 314 435; Fax: +389 2 2621 428; E-mail: sstoleski@yahoo.com§ Guest Editors.






Chronic obstructive airway diseases (asthma, chronic obstructive pulmonary disease, bronchiectasis, and cystic fibrosis) are chronic inflammatory disorders characterized by airflow obstruction and subsequent airflow limitation. Airflow limitation can be present in different severities and clinical expressions.

These diseases, especially asthma and chronic obstructive pulmonary disease (COPD), cause considerable morbidity and mortality and consume substantial and increasing health care resources, this have become important global public health problem in the last decades. There is evidence that asthma affects 1-18% of the population in different countries [1Global Initiative for Asthma: Revised 2014. Available at: wwwginasthmacom Assessed February 16 2015.]. In addition, COPD is one of the most important causes of death in most countries, i.e. it is estimated that COPD will become the third leading cause of death worldwide by 2020 [2Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: 2014 Update. Available at: http://wwwgoldcopdorg/ Assessed February 16 2015.].

Despite increasing knowledge about the mechanisms, patophysiology, diagnostics, and treatment of these diseases, the problem of chronic obstructive airway disease remains far from being solved. From the doctors’ point of view there are still many controversies in all aspects of these diseases. From the patients’ point of view there are still many unmet needs, as well.

The best illustration of this maybe is still an ongoing debate between the Dutch hypothesis and the British hypothesis. In 1961, Orie et al. [3Orie NGM, Sluiter HJ, Orie NGM, Eds., et al. The host factors in bronchitis. Bronchitis Assen: Royal van Gorcum. 1961.] put forward the hypothesis that various forms of airway obstruction, such as asthma, chronic bronchitis and emphysema, should not be considered as separated diseases but rather as different expressions of one disease entity: chronic non-specific lung disease (CNSLD). In 1969, Fletcher et al. [4Fletcher C, Peto R, Tinker C, Speizer FE, Eds. The natural history of chronic bronchitis and emphysema. London: Oxford University Press. 1976.] suggested the name Dutch hypothesis. The principle of the Dutch hypothesis is that various forms of obstructive airway disease overlap clinical features, and suggest using a number of defining characteristics (symptoms and signs, allergy, bronchial hyperresponsiveness, etc.) to describe the individual patient with CNSLD, rather than trying to categorize a patient with specific disease label [5Sluiter HJ, Koeter GH, De Monchy JGR, Postma DS, De Vries K, Orie NGM. The Dutch hypothesis (chronic non-specific lung disease) revisited. Eur Respir J 1991; 4: 479-89.]. On the contrary, the British hypothesis [6Barnes PJ. Against the Dutch hypothesis: asthma and chronic obstructive pulmonary disease are distinct diseases. Am J Respir Crit Care Med 2006; 174: 240-43.] suggests that asthma and COPD are distinct entities generated by different mechanisms, i.e. there are marked differences in the patterns of the underlying inflammation, cellular mechanisms, inflammatory mediators, and response to therapy between asthma and COPD. This issue remains hotly debated particularly as we are entering a new era of molecular phenotyping and targeted biologic therapies. Results from actual study based on biological clustering of asthma and COPD indicate that sputum cytokine profiling can determine distinct and overlapping groups of patients with asthma and COPD, supporting both the Dutch and British hypothesis of airway disease [7Ghebre MA, Bafadhel M, Desai D , et al. Biological clustering supports both “Dutch” and “British” hypothesis of asthma and chronic obstructive pulmonary disease. J Allergy Clin Immunol 2015; 135: 63-72.]. Furthermore, from the clinical point of view, distinguishing asthma from COPD can be problematic, particularly in smokers and older adults. The Asthma COPD overlap syndrome (ACOS) is a clinical entity characterized by persistent airflow limitation with several features usually associated with asthma and several features usually associated with COPD. Such consensus-based description of the ACOS is intended to stimulate further study of the character and treatments for this common clinical problem [1Global Initiative for Asthma: Revised 2014. Available at: wwwginasthmacom Assessed February 16 2015.].

What can we say? There is no doubt that the knowledge about chronic obstructive airway diseases is growing and it is a reflection of the progress that has been made. However, there is always a need of further investigations of different aspects of these diseases. In addition, every study represents a small piece of knowledge that participates in the whole knowledge of this field of respiratory medicine.

REFERENCES

[1] Global Initiative for Asthma: Revised 2014. Available at: wwwginasthmacom Assessed February 16 2015.
[2] Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: 2014 Update. Available at: http://wwwgoldcopdorg/ Assessed February 16 2015.
[3] Orie NGM, Sluiter HJ, Orie NGM, Eds., et al. The host factors in bronchitis. Bronchitis Assen: Royal van Gorcum. 1961.
[4] Fletcher C, Peto R, Tinker C, Speizer FE, Eds. The natural history of chronic bronchitis and emphysema. London: Oxford University Press. 1976.
[5] Sluiter HJ, Koeter GH, De Monchy JGR, Postma DS, De Vries K, Orie NGM. The Dutch hypothesis (chronic non-specific lung disease) revisited. Eur Respir J 1991; 4: 479-89.
[6] Barnes PJ. Against the Dutch hypothesis: asthma and chronic obstructive pulmonary disease are distinct diseases. Am J Respir Crit Care Med 2006; 174: 240-43.
[7] Ghebre MA, Bafadhel M, Desai D , et al. Biological clustering supports both “Dutch” and “British” hypothesis of asthma and chronic obstructive pulmonary disease. J Allergy Clin Immunol 2015; 135: 63-72.
Track Your Manuscript:


Endorsements



"Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines."


Daniel Pesut
(Indiana University School of Nursing, USA)

"It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor."


Jacques Descotes
(Centre Antipoison-Centre de Pharmacovigilance, France)

"Publishing research articles is the key for future scientific progress. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community."


Patrice Talaga
(UCB S.A., Belgium)

"Open access journals are a novel concept in the medical literature. They offer accessible information to a wide variety of individuals, including physicians, medical students, clinical investigators, and the general public. They are an outstanding source of medical and scientific information."


Jeffrey M. Weinberg
(St. Luke's-Roosevelt Hospital Center, USA)

"Open access journals are extremely useful for graduate students, investigators and all other interested persons to read important scientific articles and subscribe scientific journals. Indeed, the research articles span a wide range of area and of high quality. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals."


Debomoy K. Lahiri
(Indiana University School of Medicine, USA)

"Open access journals represent a major break-through in publishing. They provide easy access to the latest research on a wide variety of issues. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Articles are of uniformly high quality and written by the world's leading authorities."


Robert Looney
(Naval Postgraduate School, USA)

"Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets."


Richard Reithinger
(Westat, USA)

"Not only do open access journals greatly improve the access to high quality information for scientists in the developing world, it also provides extra exposure for our papers."


J. Ferwerda
(University of Oxford, UK)

"Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content."


Sean L. Kitson
(Almac Sciences, Northern Ireland)

"In principle, all scientific journals should have open access, as should be science itself. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. The articles are high standard and cover a wide area."


Hubert Wolterbeek
(Delft University of Technology, The Netherlands)

"The widest possible diffusion of information is critical for the advancement of science. In this perspective, open access journals are instrumental in fostering researches and achievements."


Alessandro Laviano
(Sapienza - University of Rome, Italy)

"Open access journals are very useful for all scientists as they can have quick information in the different fields of science."


Philippe Hernigou
(Paris University, France)

"There are many scientists who can not afford the rather expensive subscriptions to scientific journals. Open access journals offer a good alternative for free access to good quality scientific information."


Fidel Toldrá
(Instituto de Agroquimica y Tecnologia de Alimentos, Spain)

"Open access journals have become a fundamental tool for students, researchers, patients and the general public. Many people from institutions which do not have library or cannot afford to subscribe scientific journals benefit of them on a daily basis. The articles are among the best and cover most scientific areas."


M. Bendandi
(University Clinic of Navarre, Spain)

"These journals provide researchers with a platform for rapid, open access scientific communication. The articles are of high quality and broad scope."


Peter Chiba
(University of Vienna, Austria)

"Open access journals are probably one of the most important contributions to promote and diffuse science worldwide."


Jaime Sampaio
(University of Trás-os-Montes e Alto Douro, Portugal)

"Open access journals make up a new and rather revolutionary way to scientific publication. This option opens several quite interesting possibilities to disseminate openly and freely new knowledge and even to facilitate interpersonal communication among scientists."


Eduardo A. Castro
(INIFTA, Argentina)

"Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. The articles published in the open access journals are high quality and cover a wide range of fields."


Kenji Hashimoto
(Chiba University, Japan)

"Open Access journals offer an innovative and efficient way of publication for academics and professionals in a wide range of disciplines. The papers published are of high quality after rigorous peer review and they are Indexed in: major international databases. I read Open Access journals to keep abreast of the recent development in my field of study."


Daniel Shek
(Chinese University of Hong Kong, Hong Kong)

"It is a modern trend for publishers to establish open access journals. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category."


Jih Ru Hwu
(National Central University, Taiwan)


Browse Contents



Table of Contents


Webmaster Contact: info@benthamopen.net
Copyright © 2020 Bentham Open