Research summary
Successive revisions of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy documents codify the diagnostic and management framework for COPD. The 2007 revision required spirometry for clinical diagnosis (to avoid misdiagnosis), graded severity by post-bronchodilator FEV1, and combined symptom-and-exacerbation assessment in management decisions [3]. The 2012 revision integrated accumulated phenotype-based management evidence and added comorbidity-screening recommendations as routine COPD care [1]. The 2017 revision separated spirometric severity from symptom-based ABCD grouping (derived only from symptoms and exacerbation history), proposed escalation strategies for pharmacological treatment within each ABCD group, and introduced the explicit concept of treatment de-escalation [4]. The 2019 GOLD science committee report then introduced blood eosinophil counts as a biomarker to target inhaled-corticosteroid therapy in COPD patients with continued exacerbations despite appropriate bronchodilator therapy, situating ICS use inside a precision-medicine framework [6]. The systemic dimension of COPD is reviewed in detail: airflow obstruction has direct effects on cardiac function and gas exchange, while spill-over of inflammatory mediators into the systemic circulation drives skeletal-muscle wasting and cachexia, and contributes to ischemic heart disease, heart failure, osteoporosis, normocytic anemia, lung cancer, depression, and diabetes; the review reframes COPD as a multi-system condition with overlapping comorbidity rather than an isolated airways disorder [7]. A broader mechanistic argument places NF-κB at the center of chronic inflammatory disease, including asthma, rheumatoid arthritis, inflammatory bowel disease, and psoriasis, by linking cytokine-driven recruitment of activated immune cells to amplification of the inflammatory state; the framework explains how genetic susceptibility (atopy genes, HLA antigens) and environmental triggers converge on a common transcriptional program centred on this inducible transcription factor [2]. A parallel GINA executive summary translates accumulated asthma research into adaptable management recommendations for varying local resources, drawing on the Global Initiative for Asthma's continuous-review network to disseminate care guidance [5].
Recent publications
- Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary DiseaseDOI
- Nuclear Factor-κB — A Pivotal Transcription Factor in Chronic Inflammatory DiseasesDOI
- Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary DiseaseDOI
- Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive SummaryDOI
- Global strategy for asthma management and prevention: GINA executive summaryDOI
- Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019DOI
- Sex and gender: modifiers of health, disease, and medicineDOI
- Effects of an interleukin-5 blocking monoclonal antibody on eosinophils, airway hyper-responsìveness, and the late asthmatic responseDOI
- Systemic manifestations and comorbidities of COPDDOI
- Inflammatory mechanisms in patients with chronic obstructive pulmonary diseaseDOI
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External profiles
- ORCID: https://orcid.org/0000-0002-5122-4018
- OpenAlex: openalex.org
Profile compiled from public sources (Researchmap, OpenAlex, Tohoku University faculty directory). Last refreshed 2026-05. Report incorrect information.