The Many Faces of Chronic Obstructive Pulmonary Disease: Moving Towards Precision Medicine

Abstract

When the term chronic obstructive pulmonary disease (COPD) was first used in 1970s, it included two main phenotypes: the "blue bloater" (chronic bronchitis) and "pink puffer" (emphysema). Recently, as our current knowledge on the disease has progressed, the attention has been drawn to very diverse subtypes of chronic airflow obstruction characterised by different causes, age of onset, pathological and clinical manifestations. Over the years, "recommendations" have been generated for the clinicians on how to manage the patients with COPD, such as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations. Although the GOLD recommendations had the great merit to draw attention onto the COPD severity and its clinical management, they are now less suitable to address the extremely diverse nature of COPD. This review will give an overview of the history of COPD, and the many faces of COPD over the years to date. (BRN Rev. 2019;5(2):90-103)