Written by Sandy Cho, MD
COPD (Chronic Obstructive Pulmonary Disease) is a preventable and treatable disease state characterized by airflow limitation that is not fully reversible. It is the fourth leading cause of death in the United States.
What is COPD?
COPD (Chronic Obstructive Pulmonary Disease) is a preventable and treatable disease state characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily caused by cigarette smoking. COPD has a debilitating effect on the patient leading to disability and sometimes death.
The disease represents a substantial public health burden, affecting 10 million to 15 million people in the United States. Currently, COPD is the fourth leading cause of death in the United States, accounting for 120,000 deaths annually, and it is expected to be the third leading cause of death by 2020.
What are signs/symptoms?
COPD is characterized by recurrent episodes of:
- Sputum production
- Shortness of breath (dyspnea), especially upon exertion
- Chest tightness
What causes COPD?
In the United States, the most common irritant that causes COPD is cigarette smoke. Breathing in secondhand smoke, air pollution, or chemical fumes or dust from the environment or workplace also can contribute to COPD.
An uncommon genetic disorder known as alpha-1-antitrypsin deficiency may cause some cases of COPD. Other genetic factors likely make certain smokers more susceptible to the disease.
What are conventional treatments for COPD?
Current COPD therapies primarily include inhaled corticosteroids (ICS), long-acting and short-acting beta agonists (LABAs and SABAs), long-acting and short-acting muscarinic antagonists (LAMAs and SAMAs) and combination therapies. More than half of severe or very severe COPD patients are on triple therapy (LABA, LAMA and ICS) for COPD maintenance.
Smoking cessation is essential at any stage of the disease. Although lung damage will not be reversed, smoking cessation will lead to improvements in pulmonary function.
Studies have shown that people following a Western diet, high in refined grains, cured and red meats, desserts, and french fries, have a greater risk for developing COPD, while those following largely plant-based diets have a lower risk.
Supplementation with an omega 3-containing calorie supplement (400 cals/day) for 2 years significantly improved dyspnea and reduced the rate of decline in arterial oxygen saturation.
The use of antioxidants in reducing the inflammation and consequent lung damage in COPD is being investigated. One such antioxidant is red wine extract, or resveratrol. In one study it was found that resveratrol can inhibit the release of proinflammatory proteins called cytokines in the lung. A good starting dose is 200-250 mg daily.
Other antioxidants are likely to be beneficial in the treatment of COPD as well. The goal of treatment is to raise intracellular glutathione levels to counteract the oxidative stress and free radical load and minimize further lung damage brought on by the COPD-related inflammation. Antioxidants such as alpha lipoic acid, turmeric, quercetin, and N-acetylcysteine can be helpful in this regard.
- Aerobic exercise: Aerobic exercise includes walking, jogging, jumping rope, bicycling (stationary or outdoor), cross-country skiing, skating, rowing, and low-impact aerobics or water aerobics. This type of exercise strengthens the heart and lungs, and improves the body’s ability to use oxygen. Over time, aerobic exercise can help decrease your heart rate and blood pressure, and improve your breathing (since your heart won’t have to work as hard during exercise).
- Strength exercise: Strengthening exercises for the upper body are especially helpful for people with COPD, as they help increase the strength of your respiratory muscles.
- Anthonisen NR, Skeans MA, Wise RA, Manfreda J, Kanner RE, Connett JE. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med. 2005;142(4):233-239.
- Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013.
- Jemal A, Ward E, Hao Y, Thun M. Trends in the leading causes of death in the United States, 1970-2002. JAMA. 2005;294(10):1255-1259.
- Knobloch J, Hag H et al. Resveratrol impairs the release of steroid-resistant cytokines from bacterial endotoxin-exposed alveolar macrophages in chronic obstructive pulmonary disease. Basic Clinical Pharmacology and Toxicology. 2011 Aug;109(2):138-43.
- Matsuyama W, Mitsuyama H, Watanabe M, et al. Effects of omega-3 polyunsaturated fatty acids on inflammatory markers in COPD. Chest. 2005;128:3817-3827.
- Rahman I. Antioxidant therapeutic advances in COPD. Therapeutic Advances in Respiratory Disease. 2008 Dec;2(6):351-74.
- Varraso R, Fung TT, Hu FB, Willett W, Camargo CA Jr. Prospective study of dietary patterns and chronic obstructive pulmonary disease among US men. Thorax. 2007;62:785-790.
- Varraso R, Fung TT, Hu FB, Willett W, Camargo CA Jr. Prospective study of dietary patterns and chronic obstructive pulmonary disease among US women. Am J Clin Nutr. 2007;86:488-495.
Updated: May 2014