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Inicio Medicina Clínica (English Edition) Beyond the COPD-tobacco binomium: New opportunities for the prevention and early...
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Vol. 159. Issue 1.
Pages 33-39 (July 2022)
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Vol. 159. Issue 1.
Pages 33-39 (July 2022)
Review
Beyond the COPD-tobacco binomium: New opportunities for the prevention and early treatment of the disease
Más alla del binomio EPOC-tabaco: nuevas oportunidades para la prevención y tratamiento precoz de la enfermedad
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Marc Vilaa,b, Rosa Fanerb,c,d, Alvar Agustíb,e,
Corresponding author
aagusti@clinic.cat

Corresponding author.
a Equip d’Assistència Primària Vic (EAP VIC), Barcelona, Spain
b Càtedra Salut Respiratòria, Universitat Barcelona, Barcelona, Spain
c Respiratory Institute, Hospital Clínic, Barcelona, Spain
d Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
e CIBER Enfermedades Respiratorias, Madrid, Spain
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Abstract

Chronic Obstructive Pulmonary Disease (COPD) has been traditionally understood as a self-inflicted disease cause by tobacco smoking occurring in individuals older than 50–60 years. This traditional paradigm has changed over the last decade because new scientific evidence showed that there are many genetic (G) and environmental (E) factors associated with reduced lung function, that vary, accumulate, and interact over time (T), even before birth (GxExT). This new perspective opens novel windows of opportunity for the prevention, early diagnosis, and personalized treatment of COPD. This review presents the evidence that supports this proposal, as well as its practical implications, with particular emphasis on the need that clinical histories in patients with suspected COPD should investigate early life events and that spirometry should be used much more widely as a global health marker.

Keywords:
Bronchitis
Lung development
Chronicobstructive pulmonary disease
Aging
Prevention
Early ages
Resumen

La enfermedad pulmonar obstructiva crónica (EPOC) ha sido tradicionalmente entendida como una enfermedad auto infringida por el hábito tabáquico que ocurre en adultos de más de 50–60 años. Este paradigma tradicional ha cambiado en los últimos diez años por la aparición de nueva evidencia científica que muestra que existen otros muchos factores genéticos (G) y del entorno (E) asociados a baja función pulmonar, que varían, se acumulan e interaccionan con el tiempo (T), incluso desde antes del nacimiento (GxExT). Esta nueva perspectiva abre nuevas ventanas de oportunidad temporal para la prevención, diagnóstico temprano y terapéutica personalizada de la EPOC. Esta revisión presenta esta nueva evidencia científica y discute las implicaciones prácticas que comporta, con especial énfasis en la importancia de una historia clínica que recoja posibles eventos tempranos en la vida y el uso de la espirometría forzada como marcador de salud global.

Palabras clave:
Bronquitis
Desarrollo pulmonar
Enfermedad pulmonar obstructiva crónica
Envejecimiento
Prevención
Edades tempranas

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