Definition and Nomenclature of Chronic Obstructive Pulmonary Disease: Time for Its Revision

Abstract

Attempts to define concepts and things date back to the time of Aristotle, around 2,400 years ago, when he proposed that a definition should state the essential nature or being of something (1). However, this abstract concept (2-4) may not translate well to medical practice, where precise definitions are needed to communicate to colleagues and patients and to conduct epidemiological, clinical, translational, and discovery research in the presence of new evidence brought about by scientific progress. Since Aristotle's initial discussions, the last 24 centuries have witnessed the appearance and evolution of definitions of many things that surround us, including diseases (5). In medicine, accurate and precise definitions (nosology) and classification of diseases (taxonomy) allow thinking, speaking, and writing about observable phenomena in an understandable and unified way.

Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary

“…The definition of a disease should only include the characteristics that distinguish it from other diseases [ 2 ]. Accordingly, GOLD 2023 proposes a new definition of COPD that, at variance with previous documents [ 3 ], focuses exclusively on these characteristics, separately from its epidemiology, causes, risk factors and diagnostic criteria that are discussed on their own.…”

“…Based on the different causes (or etiotypes ) that can contribute to COPD (see above) GOLD 2023 proposes a new taxonomic classification of COPD ( figure 1 ) that reflects two recent proposals [ 2 , 72 ]. It aims to raise awareness about nonsmoking-related COPD and to stimulate research on the mechanisms and corresponding diagnostic, preventive or therapeutic approaches for these other etiotypes of COPD which are highly prevalent around the globe [ 13 ].…”

Chronic Obstructive Pulmonary Disease Definition: Is It Time to Incorporate the Concept of Failure of Lung Regeneration?

“…We applaud the proposal of Celli and colleagues ( 1 ) to provide an updated definition of chronic obstructive pulmonary disease (COPD), driven by the slow progress of therapeutic interventions to decrease morbidity and mortality. This authoritative group of experts focused on two main limitations of the previous COPD definition: 1 ) the lack of identification of the disorder at its early stages in the absence of flow limitation; and 2 ) the consideration of COPD as a single disease despite diverse causes other than cigarette smoking.…”

Definition of Chronic Obstructive Pulmonary Disease: Occupational Environmental Contribution

“…The recent proposal to reclassify chronic obstructive pulmonary disease appropriately identifies environmentally related disease ( 1 ). However, in addition to biomass and pollution exposure, the critical role of occupation in the development ( 2 ) and worsening ( 3 ) of chronic obstructive pulmonary disease should be acknowledged.…”