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Lung microbiology and exacerbations in COPD

Authors Beasley V, Joshi PV, Singanayagam A, Molyneaux PL, Johnston SL, Mallia P

Received 4 May 2012

Accepted for publication 2 July 2012

Published 31 August 2012 Volume 2012:7 Pages 555—569

DOI http://dx.doi.org/10.2147/COPD.S28286

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Victoria Beasley,2 Priya V Joshi,2 Aran Singanayagam,1,2 Philip L Molyneaux,1,2 Sebastian L Johnston,1,2 Patrick Mallia,1,2

1
National Heart and Lung Institute, Imperial College London, London, UK; 2Imperial College Healthcare NHS Trust, London, UK

Abstract: Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory condition in adults and is characterized by progressive airflow limitation that is not fully reversible. The main etiological agents linked with COPD are cigarette smoking and biomass exposure but respiratory infection is believed to play a major role in the pathogenesis of both stable COPD and in acute exacerbations. Acute exacerbations are associated with more rapid decline in lung function and impaired quality of life and are the major causes of morbidity and mortality in COPD. Preventing exacerbations is a major therapeutic goal but currently available treatments for exacerbations are not very effective. Historically, bacteria were considered the main infective cause of exacerbations but with the development of new diagnostic techniques, respiratory viruses are also frequently detected in COPD exacerbations. This article aims to provide a state-of-the art review of current knowledge regarding the role of infection in COPD, highlight the areas of ongoing debate and controversy, and outline emerging technologies and therapies that will influence future diagnostic and therapeutic pathways in COPD.

Keywords: COPD, exacerbations, bacteria, viruses

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