Mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease

Exacerbations of chronic obstructive pulmonary disease (COPD) are important events that carry significant consequences for patients. Some patients experience frequent exacerbations, and are now recognized as a distinct clinical subgroup, the ‘frequent exacerbator’ phenotype. This is relatively stabl...

Full description

Bibliographic Details
Main Authors:	Wedzicha, Jadwiga A, Brill, Simon E, Allinson, James P, Donaldson, Gavin C
Format:	Online
Language:	English
Published:	BioMed Central 2013
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3750926/

id	pubmed-3750926
recordtype	oai_dc
spelling	pubmed-37509262013-08-27 Mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease Wedzicha, Jadwiga A Brill, Simon E Allinson, James P Donaldson, Gavin C Review Exacerbations of chronic obstructive pulmonary disease (COPD) are important events that carry significant consequences for patients. Some patients experience frequent exacerbations, and are now recognized as a distinct clinical subgroup, the ‘frequent exacerbator’ phenotype. This is relatively stable over time, occurs across disease severity, and is associated with poorer health outcomes. These patients are therefore a priority for research and treatment. The pathophysiology underlying the frequent exacerbator phenotype is complex, with increased airway and systemic inflammation, dynamic lung hyperinflation, changes in lower airway bacterial colonization and a possible increased susceptibility to viral infection. Frequent exacerbators are also at increased risk from comorbid extrapulmonary diseases including cardiovascular disease, gastroesophageal reflux, depression, osteoporosis and cognitive impairment. Overall these patients have poorer health status, accelerated forced expiratory volume over 1 s (FEV1) decline, worsened quality of life, and increased hospital admissions and mortality, contributing to increased exacerbation susceptibility and perpetuation of the frequent exacerbator phenotype. This review article sets out the definition and importance of the frequent exacerbator phenotype, with a detailed examination of its pathophysiology, impact and interaction with other comorbidities. BioMed Central 2013-08-14 /pmc/articles/PMC3750926/ /pubmed/23945277 http://dx.doi.org/10.1186/1741-7015-11-181 Text en Copyright © 2013 Wedzicha et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Wedzicha, Jadwiga A Brill, Simon E Allinson, James P Donaldson, Gavin C
spellingShingle	Wedzicha, Jadwiga A Brill, Simon E Allinson, James P Donaldson, Gavin C Mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease
author_facet	Wedzicha, Jadwiga A Brill, Simon E Allinson, James P Donaldson, Gavin C
author_sort	Wedzicha, Jadwiga A
title	Mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease
title_short	Mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease
title_full	Mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease
title_fullStr	Mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease
title_full_unstemmed	Mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease
title_sort	mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease
description	Exacerbations of chronic obstructive pulmonary disease (COPD) are important events that carry significant consequences for patients. Some patients experience frequent exacerbations, and are now recognized as a distinct clinical subgroup, the ‘frequent exacerbator’ phenotype. This is relatively stable over time, occurs across disease severity, and is associated with poorer health outcomes. These patients are therefore a priority for research and treatment. The pathophysiology underlying the frequent exacerbator phenotype is complex, with increased airway and systemic inflammation, dynamic lung hyperinflation, changes in lower airway bacterial colonization and a possible increased susceptibility to viral infection. Frequent exacerbators are also at increased risk from comorbid extrapulmonary diseases including cardiovascular disease, gastroesophageal reflux, depression, osteoporosis and cognitive impairment. Overall these patients have poorer health status, accelerated forced expiratory volume over 1 s (FEV1) decline, worsened quality of life, and increased hospital admissions and mortality, contributing to increased exacerbation susceptibility and perpetuation of the frequent exacerbator phenotype. This review article sets out the definition and importance of the frequent exacerbator phenotype, with a detailed examination of its pathophysiology, impact and interaction with other comorbidities.
publisher	BioMed Central
publishDate	2013
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3750926/
_version_	1612005301330903040

Mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease

Similar Items