![]() Moreover, some other genetic factors can be involved in the establishment of COPD, such as the Alpha1-antitrypsin deficiency ( 9).Īnother important risk factor is reduced Daily Physical Activity (DPA), which might be considered an important cause of cardiovascular (CV) morbidity ( 10).ĬOPD pathophysiology is also influenced by toxic particles inhalation ( 11), which indeed may lead to chronic inflammation that might exacerbate the COPD prognosis ( 12). However, multiple risk factors might be involved in the development of the disease which can be classified into environment-related risk factors and patient-related risk factors, such as respiratory infections, occupational exposures, ambient air pollution, passive smoke exposure, and diet. Moreover, COPD prevalence is likely to increase in the coming years due to higher smoking habits and aging populations ( 5).Īlthough the development of COPD might be considered multifactorial ( 6), smoking can be considered the most important environmental risk factor in the development of COPD ( 7), leading to a rapid decline in lung function and an increase in mortality in smokers compared to non-smokers ( 8). ![]() According to the World Health Organization (WHO), 251 million cases of COPD were globally reported in 2016 and it is estimated that 3.17 million deaths were caused by the disease in 2015 ( 5). Over the lifetime, COPD might predispose to exacerbations and serious illness ( 5). According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) initiative, the airflow limitation “is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases” ( 4). Above all, many robust data are now available on the effectiveness of the triple therapy to reduce mortality in COPD patients.Ĭhronic obstructive pulmonary disease (COPD) is a slowly progressive ( 1) complex disease, which consists in the reduction of the airflow and leads to the disruption of the pulmonary tissue due to a chronic inflammation ( 2, 3). The efficacy and safety of triple inhaled therapy were demonstrated by numerous controlled trials. Mortality represents the most important COPD outcome, with an increased risk in patients with cardiovascular comorbidities. The progression of the disease is characterized by an exacerbation of the symptoms and the presence of life-threatening systemic complications, such as stroke and ischemic heart disease, with a progressive decline in lung function which can deeply impact the quality of life. 5Translational Medicine Department, University of Piemonte Orientale, Novara, ItalyĬhronic obstructive pulmonary disease (COPD) is a complex disease which consists in the reduction of the airflow and leads to the disruption of the pulmonary tissue due to a chronic inflammation.4Division of Respiratory Diseases, Medical and Specialistic Department, AOU Maggiore della Carità, Novara, Italy.3Allergy and Clinical Immunology Unit, AO Ordine Mauriziano Hospital, Turin, Italy.2Department of Medical Sciences, University of Turin, Turin, Italy.1Division of University Respiratory Medicine, Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino, Turin, Italy.Paolo Solidoro 1,2 Carlo Albera 1,2 Fulvia Ribolla 1 Michela Bellocchia 1 Luisa Brussino 2,3 † Filippo Patrucco 4,5 * †
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