Number and order of whole cell pertussis vaccines in infancy and disease protection (JAMA - Journal of the American Medical Association (2012) 308 5, (454-456))

摘要

Chronic obstructive pulmonary disease is characterized by chronic airflow limitation, caused by pulmonary emphysema, large airways disease, and inflammation with remodeling of the smallest conducting airways, each contributing in varying degrees. Clinical diagnosis of COPD is usually late in the course of the disease, when patients become symptomatic. Today, the disease components can be quantified automatically using automated CT analysis tools, and recently screening CT has been shown to be useful for detecting early stages of COPD.3 External validation is still needed, but adding other quantitative markers, such as airway wall dimensions, may enable even better diagnostic performance. These other CT markers may also help separate various phenotypes of COPD: predominant emphysema, involvement of the large bronchi, or small airways disease. Detection of early stages of the disease together with a better characterization may become an important step toward developing more tailored treatments based on disease phenotype. Moreover, the diagnosis of COPD or emphysema is associated with an increased incidence of lung cancer independent of cumulative smoking history, which suggests that stricter screening regimens may be warranted.