Chronic Obstructive Pulmonary Disease (COPD) is characterized by a persistent airflow limitation that is progressive and interferes with normal breathing. It is one of the leading, yet under-recognized causes of morbidity and mortality worldwide. Worldwide, nearly 190 million people are estimated to have COPD with more than 15 million adults diagnosed in the US. The US annual healthcare burden with COPD is estimated at $50 billion per year.
COPD is an umbrella term used to describe a group of diseases, such as small airway disease (chronic bronchitis) and emphysema, characterized by chronic and incompletely reversible airway obstruction that interferes with normal breathing.
Airway obstruction (narrowing of the airways) can result from any combination of four basic mechanisms;
- Smooth muscle contraction leading to bronchoconstriction causes a narrowing of the airway
- Excess mucous production leading to blockage of the airway opening
- Thickening of the airway wall, which may be the result of a combination of inflammation or hypertrophy of the smooth muscle or mucous glands.
- Alteration of structures around the airway, such as emphysematous destruction of the lung tissue itself, can lead to a loss of radial traction on the airway wall with subsequent airway narrowing.
These four basic mechanisms combine to produce widespread and variable airflow obstruction that makes it difficult for patients to breathe and produces symptoms of shortness of breath (dyspnea), wheezing, chest tightness, and a productive cough.
Pharmacological treatment is the approach for most patients. Inhaled drugs are used once or twice daily to relax and temporarily open airways. Other forms of treatment include: pulmonary rehabilitation, oxygen administration and surgical intervention.
Holaira is developing a minimally invasive device to treat COPD. This simple, one-time bronchoscopic treatment, called Targeted Lung Denervation or TLD, has the potential to provide lasting whole lung improvement for COPD patients by opening obstructed airways to make breathing easier. TLD is under clinical investigation and is not yet commercially available.
For more information about COPD, the following websites may be useful:
Global Initiative for Chronic Obstructive Lung Disease (GOLD)
European Respiratory Society (ERS)
European Lung Foundation
American Lung Association
National Heart Lung and Blood Institute
For current COPD treatment options, please consult a healthcare professional.
 COPD, May 2013, TDI, Inc.
 CDC MMWR, Nov 23 2012, Vol 61, No.46
 American Lung Association, COPD Fact Sheet, February 2011