Pathophysiology, clinical manifestation, and treatment of tuberculosis-associated chronic obstructive pulmonary disease: a narrative review
Chronic obstructive pulmonary disease (COPD) is a leading cause of respiratory morbidity and mortality, most often linked to smoking. However, growing evidence indicates that previous tuberculosis (TB) infection is also a critical risk factor for COPD. This review aimed at providing a comprehensive...
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| Language: | English |
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Ewha Womans University College of Medicine
2025-04-01
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| Series: | The Ewha Medical Journal |
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| Online Access: | http://www.e-emj.org/upload/pdf/emj-2025-00059.pdf |
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| author | Joon Young Choi |
| author_facet | Joon Young Choi |
| author_sort | Joon Young Choi |
| collection | DOAJ |
| description | Chronic obstructive pulmonary disease (COPD) is a leading cause of respiratory morbidity and mortality, most often linked to smoking. However, growing evidence indicates that previous tuberculosis (TB) infection is also a critical risk factor for COPD. This review aimed at providing a comprehensive perspective on TB-COPD, covering its epidemiologic significance, pathogenesis, clinical characteristics, and current management approaches. Tuberculosis-associated chronic obstructive pulmonary disease (TB-COPD) is characterized by persistent inflammatory responses, altered immune pathways, and extensive structural lung damage—manifested as cavitation, fibrosis, and airway remodeling. Multiple epidemiologic studies have shown that individuals with a history of TB have a significantly higher likelihood of developing COPD and experiencing worse outcomes, such as increased breathlessness and frequent exacerbations. Key pathogenic mechanisms include elevated matrix metalloproteinase activity and excessive neutrophil-driven inflammation, which lead to alveolar destruction, fibrotic scarring, and the development of bronchiectasis. Treatment generally follows current COPD guidelines, advocating the use of long-acting bronchodilators and the selective application of inhaled corticosteroids. Studies have demonstrated that indacaterol significantly improves lung function and respiratory symptoms, while long-acting muscarinic antagonists have shown survival benefits. |
| format | Article |
| id | doaj-art-b4d8167dd13f4b23b7980ab4e5e1864d |
| institution | Kabale University |
| issn | 2234-3180 2234-2591 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Ewha Womans University College of Medicine |
| record_format | Article |
| series | The Ewha Medical Journal |
| spelling | doaj-art-b4d8167dd13f4b23b7980ab4e5e1864d2025-08-26T00:04:46ZengEwha Womans University College of MedicineThe Ewha Medical Journal2234-31802234-25912025-04-0148210.12771/emj.2025.000591605Pathophysiology, clinical manifestation, and treatment of tuberculosis-associated chronic obstructive pulmonary disease: a narrative reviewJoon Young Choi0Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaChronic obstructive pulmonary disease (COPD) is a leading cause of respiratory morbidity and mortality, most often linked to smoking. However, growing evidence indicates that previous tuberculosis (TB) infection is also a critical risk factor for COPD. This review aimed at providing a comprehensive perspective on TB-COPD, covering its epidemiologic significance, pathogenesis, clinical characteristics, and current management approaches. Tuberculosis-associated chronic obstructive pulmonary disease (TB-COPD) is characterized by persistent inflammatory responses, altered immune pathways, and extensive structural lung damage—manifested as cavitation, fibrosis, and airway remodeling. Multiple epidemiologic studies have shown that individuals with a history of TB have a significantly higher likelihood of developing COPD and experiencing worse outcomes, such as increased breathlessness and frequent exacerbations. Key pathogenic mechanisms include elevated matrix metalloproteinase activity and excessive neutrophil-driven inflammation, which lead to alveolar destruction, fibrotic scarring, and the development of bronchiectasis. Treatment generally follows current COPD guidelines, advocating the use of long-acting bronchodilators and the selective application of inhaled corticosteroids. Studies have demonstrated that indacaterol significantly improves lung function and respiratory symptoms, while long-acting muscarinic antagonists have shown survival benefits.http://www.e-emj.org/upload/pdf/emj-2025-00059.pdfbronchodilator agentschronic obstructive pulmonary diseasemuscarinic antagonistsmokingtuberculosis |
| spellingShingle | Joon Young Choi Pathophysiology, clinical manifestation, and treatment of tuberculosis-associated chronic obstructive pulmonary disease: a narrative review The Ewha Medical Journal bronchodilator agents chronic obstructive pulmonary disease muscarinic antagonist smoking tuberculosis |
| title | Pathophysiology, clinical manifestation, and treatment of tuberculosis-associated chronic obstructive pulmonary disease: a narrative review |
| title_full | Pathophysiology, clinical manifestation, and treatment of tuberculosis-associated chronic obstructive pulmonary disease: a narrative review |
| title_fullStr | Pathophysiology, clinical manifestation, and treatment of tuberculosis-associated chronic obstructive pulmonary disease: a narrative review |
| title_full_unstemmed | Pathophysiology, clinical manifestation, and treatment of tuberculosis-associated chronic obstructive pulmonary disease: a narrative review |
| title_short | Pathophysiology, clinical manifestation, and treatment of tuberculosis-associated chronic obstructive pulmonary disease: a narrative review |
| title_sort | pathophysiology clinical manifestation and treatment of tuberculosis associated chronic obstructive pulmonary disease a narrative review |
| topic | bronchodilator agents chronic obstructive pulmonary disease muscarinic antagonist smoking tuberculosis |
| url | http://www.e-emj.org/upload/pdf/emj-2025-00059.pdf |
| work_keys_str_mv | AT joonyoungchoi pathophysiologyclinicalmanifestationandtreatmentoftuberculosisassociatedchronicobstructivepulmonarydiseaseanarrativereview |