BPCO

BPCO, short for broncopneumopatia crônica obstrutiva, is a chronic, preventable and treatable disease defined by persistent respiratory symptoms and airflow limitation that is not fully reversible. The obstruction is usually progressive and results from an abnormal inflammatory response to inhaled noxious particles or gases, most commonly tobacco smoke. Other contributors include occupational exposures, indoor air pollution, and genetic factors such as alpha-1 antitrypsin deficiency.

Pathophysiology: Chronic inflammation causes small airway disease and parenchymal destruction (emphysema), leading to airflow limitation that worsens over time. Exacerbations and comorbidities, especially cardiovascular disease, are common.

Clinical features and diagnosis: Typical symptoms include chronic cough, sputum production and dyspnea on exertion; wheeze may occur. An acute exacerbation is an abrupt worsening. Diagnosis rests on spirometry showing post-bronchodilator FEV1/FVC < 0.70. Severity is assessed by FEV1 percent predicted and by symptom burden or exacerbation history.

Management: The cornerstone is smoking cessation. Treatment combines pharmacotherapy (inhaled bronchodilators such as LABA and LAMA and, where appropriate, inhaled corticosteroids) with nonpharmacologic measures like pulmonary rehabilitation, vaccination, nutrition, exercise and comorbidity management. Oxygen therapy is used for chronic hypoxemia; surgical options may be considered in selected cases.

Prognosis and prevention: BPCO is a long-term disease with variable progression. Prevention focuses on reducing risk factor exposure and early detection, notably quitting smoking and limiting air pollution. The condition imposes a substantial global health burden, particularly where smoking rates and pollution are high.