Molecular Mechanisms in Chronic Obstructive Pulmonary Disease

Dear Colleagues,

Chronic obstructive pulmonary disease (COPD) represents a significant global public health concern, resulting in substantial morbidity and mortality. COPD is believed to be the outcome of complex interactions between genetic and environmental (GxE) factors that unfold over a person's entire lifetime, from conception to death. Notably, the impacts of active smoking and exposure to secondhand smoke are well established within this context. These interactions extend beyond the respiratory system, affecting various organ systems and leading to the simultaneous development of multiple coexisting diseases as individuals age. Moreover, specific diseases tend to co-occur in COPD patients due to shared risk factors and biological interactions, compounding the disease's prognosis and societal burden, creating what is referred to as a "syndemic."

Certain chronic respiratory conditions, such as COPD, have been associated with persistent infections caused by human respiratory syncytial virus, SARS-CoV-2 and human rhinovirus. However, it remains uncertain whether RNA viruses establish long-term infections, as is acknowledged for DNA viruses like human bocavirus and adenoviruses. Torquetenovirus (TTV), a DNA virus, is implicated in immunosenescence and may play a role in the severity of COPD.

The substantial diversity within COPD has posed challenges in developing pharmaceutical treatments capable of effectively slowing the progression of the disease. Within this context, rehabilitation plays a prominent role. Precision medicine strategies offer a potential solution by focusing on understanding an individual's risk factors for the disease and tailoring treatment plans based on factors such as disease mechanisms, environmental exposures, and psychological variables. It is of paramount importance to promptly identify COPD patients at high risk of adverse outcomes and to gain a comprehensive understanding, at a mechanistic level, as to why specific individuals present an elevated risk.

Dr. Patrizia Russo
Guest Editor

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• COPD epidemiology
• COPD causes
• COPD diagnosis
• biomarkers for prediction, diagnosis and response
• pharmacology
• rehabilitation
• virus