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Sputum inflammatory cells in COPD patients classified according to GOLD 2011 guidelines

2016; European Respiratory Society; Volume: 47; Issue: 3 Linguagem: Inglês

10.1183/13993003.00784-2015

1399-3003

Maria Laura Bartoli, Francesco Costa, Laura Malagrinò, Dario Nieri, Sandra Antonelli, Giovanna Decusatis, Claudia De Simone, Sabrina Santerini, Silvana Cianchetti, Manuela Latorre, Barbara Vagaggini, Pierluigi Paggiaro,

Neonatal Respiratory Health Research

Recently the definition of chronic obstructive pulmonary disease (COPD) severity, stated in 2001 by Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines and based on forced expiratory volume in 1 s (FEV1) evaluation, has been considered inadequate to recognise all the multifaceted aspects of the disease. To overcome this limitation, 2011 GOLD recommendations suggested a new approach, which stratified COPD patients in four groups of severity (A, B, C, D) according to the level of symptoms (as assessed by either the modified Medical Research Council (mMRC) score or the COPD Assessment Test), the degree of airflow limitation (expressed as percentage of predicted forced expiratory volume in 1 s (FEV1) value) and the number of exacerbations in the previous year [1]. It is still matter of debate if this new classification helps to better understand the disease and improve COPD treatment and prognosis. Studies on the existing database have been published comparing the old with the new GOLD classifications, showing that GOLD 2011 classification adds new details on the phenotyping and on the prognosis of COPD [2–5]. Despite the many post hoc analyses performed on the large databases of the most important recent observational studies (ECLIPSE, CCLS, COPDgene), the demonstration that these different groups of GOLD 2011 classification are different for physiological and biological features is controversial. The A, B, C and D groups of the new GOLD classification are at least partly related to different COPD phenotypes