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Vol. 46. Issue S10.
Nuevos enfoques en el tratamiento de la EPOC
Pages 14-18 (December 2010)
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Vol. 46. Issue S10.
Nuevos enfoques en el tratamiento de la EPOC
Pages 14-18 (December 2010)
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Hacia un tratamiento individualizado e integrado del paciente con EPOC
Toward personalized and integrated treatment of patients with COPD
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Julio Ancocheaa,
Corresponding author
j.ancochea@separ.es

Autor para correspondencia.
, Teresa Gómez Garcíab, Javier de Miguel Díezb
a Servicio de Neumología, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, España
b Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, España
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Resumen

El concepto de enfermedad pulmonar obstructiva crónica (EPOC) es amplio y genérico. En la práctica clínica y en investigación, la definición de EPOC se basa en la medida de la limitación al flujo aéreo mediante espirometría. Sin embargo, hoy sabemos que la EPOC incluye una compleja variedad de manifestaciones celulares, anatómicas, funcionales y clínicas que pueden permitir definir diferentes fenotipos de la enfermedad. Por otra parte, la gravedad de la EPOC no sólo depende de la función pulmonar valorada mediante espirometría, sino también de otras variables como la sintomatología clínica, las exacerbaciones y la presencia de complicaciones y comorbilidades, aspectos que contribuyen a definir estos diferentes fenotipos. La heterogeneidad fenotípica puede afectar a la respuesta del paciente al tratamiento y a la evolución de la EPOC. Ésta es, pues, una enfermedad compleja en la que es preciso realizar una valoración integral y multidimensional para así establecer un tratamiento más individualizado e integrado.

Palabras clave:
Enfermedad pulmonar obstructiva crónica
Tratamiento individualizado
Fenotipos
Abstract

The concept of chronic obstructive pulmonary disease (COPD) is broad and generic. In clinical practice and research, the definition of COPD is based on the extent of airflow obstruction measured through spirometry. However, it is currently known that this disease encompasses a complex variety of cellular, anatomical, functional and clinical manifestations that could allow distinct COPD phenotypes to be defined. Moreover, the severity of COPD depends not only on pulmonary function evaluated through spirometry but also on other variables such as clinical symptoms, exacerbations and the presence of complications and comorbidities, which contribute to distinguishing among the distinct phenotypes. Phenotypic heterogeneity may affect treatment response and the clinical course of the disease. COPD is, therefore, a complex entity requiring comprehensive and multidimensional evaluation to establish more personalized and integrated treatment.

Keywords:
Chronic obstructive pulmonary disease
Individualized treatment
Phenotypes
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Copyright © 2010. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología

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