Understanding COPD Seasonality Requires Big-Picture Approach

The mechanisms underlying the seasonality of chronic obstructive pulmonary disease (COPD) exacerbation rates are multifactorial and require research that considers the issue in its entirety, according to a review article in the International Journal of Chronic Obstructive Pulmonary Disease.

“The association of COPD with seasonality is notable. Individuals with COPD recognize that they are more likely to experience exacerbations in winter, with 30% of COPD patients being frightened of this season,” researchers wrote. “The underlying mechanisms for this variance are not clear, suggesting a variety of factors including host biology, environmental conditions, and pathogen alteration.”

The review assesses current understanding of the host physiology, environmental factors, and pathogens at play in COPD seasonality but stresses the need for a more comprehensive view of causes. A greater understanding of the mechanisms that drive seasonal variations would allow for the identification of new targets and avenues of therapeutic intervention, according to the article.

“It is interesting to speculate as to how climate change will impact on these external factors, such as temperature, humidity, pollution levels, and local pathogen rates. In this study, we have discussed the factors separately although they are all clearly interconnected; importantly, with growing climate extremes, there is a risk that this will impact on seasonal variations in exacerbations rates,” researchers wrote.

“Given that patients cannot be readily relocated to milder climates during winter weather conditions, it is important to understand how all these factors have an impact together and where any interventions can be targeted.”

The piece concludes with a call for large, multicenter longitudinal studies to provide a research context for healthcare modeling in an effort to prioritize resources and figure ways to limit risk-associated exposures in patients with COPD.

—Jolynn Tumolo

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