Development of COPD study at a global level

Cooperation of mass media is called for to promote early detection and early treatment of COPD,

Professor Yoshinosuke Fukuchi
Chairman,
World COPD Day Japan Committee
Visiting professor,
Dept. of Respiratory Medicine,
Juntendo University

Circumstances surrounding COPD and latest study results

Our goals are to raise public awareness and understanding of COPD and to improve methods of diagnosis, management, and prevention. The GOLD guidelines and new definitions of COPD have come to be accepted, and it is gradually known that COPD is an abnormal pulmonary inflammation resulting mainly from smoking.

Epidemiological study of COPD is progressing in various countries of the world (Table 1). Japan is characterized by the fact that 8.6 to 10.9% of the people aged 40 and older (more than 5,300,000 people) are estimated to have COPD, 90% of whom remain undiagnosed. Similar types of investigations were conducted in China, etc., in which the morbidity was found to be 9.6%, similar to that of Japan, and it is known that the morbidity is higher in rural regions than in urban areas in China. The morbidity is essentially the same in South America, the United States, and Spain.

Pathological study of COPD as an inflammatory disease has advanced, and the progression of COPD is now known to be associated with inflammatory hyperplasia of small airways and inflammatory immune cells. It has also become clear that COPD is a systemic disease, and particularly because it is linked to arteriosclerosis, there is a greater risk for coronary artery disease (Figure 1). Furthermore, a pathogenic mechanism study using animal models suggests the possibility of genes related to aging being associated with the onset of COPD.

COPD is a preventable and treatable disease

The major way to diagnose COPD is pulmonary function testing by spirometry, which calls for active participation of the patients. At present, research is progressing on devices that can detect airflow limitations and evaluate pulmonary function without a burden on the patient, and these devices are expected to facilitate the diagnosis of COPD.

Advances are being made in clinical studies of a long-acting bronchodilator, as well as in the study of combination therapy of such drug therapy with rehabilitation therapy (Figure 2). Development of a therapeutic product with new mechanism to treat inflammation is underway, and PDE4 inhibitors are considered particularly effective in improving pulmonary function (Figure 3). Research on new smoking-cessation drugs is also advancing, and in addition to nicotine replacement therapy, we can expect to see vaccine therapy and a cannabinoid receptor antagonist as a smoking-cessation drug with an anti-obesity effect.

Because the number of patients and the number of deaths will increase over a long period of time in the future, COPD is being recognized as a serious health problem throughout the world, and COPD studies at various levels are being actively pursued and advancing rapidly.

However, COPD is a disease still unfamiliar to many, and the reality is that many patients remain undiagnosed and untreated. COPD is a preventable and treatable disease, and early detection and early treatment are essential. I would like to ask members of the media for assistance in order that many people can be properly informed of COPD and receive early diagnosis and treatment.

Table 1

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Figure 2 Enlarge	Figure 3 Enlarge