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Advances in the Personalized Management of Chronic Obstructive Pulmonary Disease...
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Advances in the Personalized Management of Chronic Obstructive Pulmonary Disease (COPD)

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Respiratory Medicine".

Deadline for manuscript submissions: 20 August 2026 | Viewed by 2290

Special Issue Editors

Dr. Athena Gogali

E-Mail Website
Guest Editor
Respiratory Medicine Department, University of Ioannina, Stavrou Niarchou Avenue, 45500 Ioannina, Greece
Interests: COPD; severe asthma; interstitial lung disease
Special Issues, Collections and Topics in MDPI journals
Dr. Georgios Hillas

E-Mail Website
Guest Editor
2nd Respiratory Medicine Department, Attikon University Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
Interests: asthma; observational studies; lung diseases; bronchiectasis; airway obstruction

Special Issue Information

Dear Colleagues,

Chronic obstructive pulmonary disease (COPD) represents a major burden for healthcare systems worldwide. Potential reasons include underdiagnosis in multiple parts of the world and the need for novel treatments beyond the currently available inhaled combinations of long-acting muscarinic antagonists (LAMAs), long-acting β-agonists (LABAs), and inhaled corticosteroids (ICSs). Modern diagnostic techniques, including the use of artificial intelligence (AI) in spirometry, oscillometry, novel imaging techniques, and the use of biomarkers, have advanced the phenotyping and endotyping of COPD patients. The proper identification of individual characteristics of COPD patients represents the basis for proper personalized management. This includes the appropriate choice of inhalation devices, the optimal recommendation of pharmacotherapy and non-pharmacologic interventions, advanced interventional treatments (including bronchoscopic lung volume reduction), non-invasive ventilation, and the appropriate management of comorbidities. The recent approval of dupilumab as the first biologic indicated for the management of exacerbating COPD patients with type 2 inflammation represents the advent of potential new candidate biologics for COPD, targetting multiple inflammatory mediators and pathways, including IL-5, TSLP, IL-33, and the ST-2 pathway. This Special Issue welcomes original research and review papers on recent diagnostic and therapeutic options that may advance the personalized management of COPD patients.

Dr. Athena Gogali
Dr. Georgios Hillas
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • artificial intelligence
  • biologics
  • biomarkers
  • diagnostics
  • oscillometry
  • COPD pharmacotherapy
  • imaging

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Published Papers (3 papers)

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Research

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12 pages, 489 KB  
Article
Association Between Phase Angle, Muscle Mass Distribution, and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease
by Lyazat Ibrayeva, Irina Bacheva and Malika Sadibekova
J. Clin. Med. 2026, 15(10), 3839; https://doi.org/10.3390/jcm15103839 - 16 May 2026
Viewed by 178
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is associated with systemic alterations in body composition, including muscle mass loss and fat redistribution, which may influence patient-reported outcomes. However, the independent contribution of bioimpedance-derived parameters, particularly phase angle, to quality of life (QoL) remains [...] Read more.
Background: Chronic obstructive pulmonary disease (COPD) is associated with systemic alterations in body composition, including muscle mass loss and fat redistribution, which may influence patient-reported outcomes. However, the independent contribution of bioimpedance-derived parameters, particularly phase angle, to quality of life (QoL) remains unclear. Methods: This exploratory pilot study included 75 clinically stable patients with moderate-to-severe COPD (GOLD stages II–III). Body composition was assessed using segmental multi-frequency bioelectrical impedance analysis with the InBody 770 system. Evaluated parameters included fat-free mass (FFM), skeletal muscle mass (SMM), percent body fat (PBF), visceral fat area (VFA), extracellular water-to-total body water ratio (ECW/TBW), bone mineral content (BMC), and phase angle (PhA). Quality of life was assessed using the WHOQOL-BREF questionnaire. Associations between body composition parameters and QoL domains were analyzed using Spearman correlation analysis and multivariable linear regression models. Results: Despite a median body mass index (BMI) within the normal range (23.4 kg/m2), body fat mass exceeded reference values in both men and women. Fat-free mass and skeletal muscle mass were located near the lower range of expected values. Correlation analysis demonstrated predominantly weak associations between body composition parameters and QoL domains. Significant positive correlations were identified between the psychological QoL domain and fat-free mass (ρ = 0.238, p = 0.041), skeletal muscle mass (ρ = 0.240, p = 0.040), basal metabolic rate (ρ = 0.236, p = 0.043), and bone mineral content (ρ = 0.249, p = 0.033). In multivariable regression models, fat-free mass and skeletal muscle mass demonstrated consistent positive associations with both physical and psychological QoL domains. Whole-body and segmental phase angle parameters did not demonstrate significant associations with QoL outcomes. Conclusions: In patients with COPD, BMI alone may inadequately reflect underlying alterations in body composition. Muscle-related parameters, particularly fat-free mass and skeletal muscle mass, demonstrated more consistent associations with physical and psychological aspects of quality of life than obesity-related indicators. These findings suggest that bioelectrical impedance analysis may provide additional clinically relevant information beyond BMI when assessing body composition and quality of life in patients with COPD. Full article
(This article belongs to the Special Issue Advances in the Personalized Management of Chronic Obstructive Pulmonary Disease (COPD))
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11 pages, 689 KB  
Article
Cerebrovascular Reactivity to Acetazolamide in Stable COPD Patients
by Péter Siró, Regina Szabó-Szűcs, Viktória Dudás, Ildikó Horváth, Béla Fülesdi and Attila Vaskó
J. Clin. Med. 2025, 14(23), 8535; https://doi.org/10.3390/jcm14238535 - 1 Dec 2025
Viewed by 566
Abstract
Background: COPD patients may be prone to cerebral small vessel disease resulting in perivascular white matter lesions and consequent cognitive decline. The pathophysiological background of these observations is not completely understood. It is hypothesized that COPD may involve systemic vascular dysfunction extending to [...] Read more.
Background: COPD patients may be prone to cerebral small vessel disease resulting in perivascular white matter lesions and consequent cognitive decline. The pathophysiological background of these observations is not completely understood. It is hypothesized that COPD may involve systemic vascular dysfunction extending to the brain. The present study aimed to assess whether acetazolamide-induced cerebral vasoreactivity and cerebrovascular reserve capacity are impaired in patients with COPD. Methods: A total of 17 patients with COPD and 20 healthy control subjects underwent transcranial Doppler monitoring before and after IV administration of 15 mg/kgBW acetazolamide for 20 min. Cerebrovascular reactivity (CVR) was defined as a percent increase in blood flow velocity in the middle cerebral artery (MBFV) after acetazolamide. Cerebrovascular reserve capacity (CVRC) was defined as the maximal percent change in MBFV during the entire registration. Results: Administration of acetazolamide resulted in a slight decrease in pH and a mild increase in PaCO2 (both p < 0.001) in COPD patients. Absolute MBFV values were consequently higher, and pulsatility indices were lower in control subjects compared to those measured in patients with COPD. The CVR at different time points after acetazolamide and CVRC did not show any difference between COPD patients and control subjects. Conclusions: In the present study, in normocapnic mild and normocapnic moderate COPD patients, cerebrovascular reactivity is not impaired, indicating that in mild stages, cerebral arteriolar function is preserved. Further studies, using patient selection based on different severity stages of the disease, may show whether alteration of the cerebral arteriolar function is responsible for the white matter lesions and cognitive decline observed in severe COPD patients. Full article
(This article belongs to the Special Issue Advances in the Personalized Management of Chronic Obstructive Pulmonary Disease (COPD))
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Review

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22 pages, 707 KB  
Review
Cardiometabolic Comorbidities in COPD: Focus on Diabetes, GLP-1 Receptor Agonists, SGLT-2 Inhibitors and Antidiabetic Drugs
by Maria Kallieri, Georgios Hillas, Stelios Loukides, Konstantinos Kostikas and Athena Gogali
J. Clin. Med. 2026, 15(5), 2082; https://doi.org/10.3390/jcm15052082 - 9 Mar 2026
Viewed by 1123
Abstract
Background/Objectives: The coexistence of chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2D) poses significant clinical challenges due to overlapping mechanisms of systemic inflammation, oxidative stress, hypoxia, and metabolic dysregulation. Patients with both conditions face higher risks of exacerbations, prolonged hospitalizations, [...] Read more.
Background/Objectives: The coexistence of chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2D) poses significant clinical challenges due to overlapping mechanisms of systemic inflammation, oxidative stress, hypoxia, and metabolic dysregulation. Patients with both conditions face higher risks of exacerbations, prolonged hospitalizations, cardiovascular events, and reduced quality of life. This review aims to summarize current evidence on the pathophysiological interplay between COPD and T2D and to evaluate the impact of lifestyle and pharmacologic interventions. Methods: A narrative review of the literature was conducted to evaluate the pathophysiological links between COPD and T2D, assess the effects of pharmacologic and lifestyle interventions, and highlight key gaps and priorities for future research, with an emphasis on integrated, evidence-based management for this high-risk population. Results: Lifestyle interventions, including smoking cessation and structured physical activity, remain foundational to management. Emerging evidence indicates that antidiabetic therapies, such as glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium–glucose cotransporter-2 inhibitors (SGLT-2is), may confer additional pulmonary, metabolic, and cardiovascular benefits. These agents modulate systemic inflammation, oxidative stress, endothelial function, and insulin sensitivity, potentially reducing COPD exacerbations, improving lung function, and enhancing survival. Safety concerns, including glucocorticoid-induced hyperglycaemia and hypoxia-related metabolic complications, underscore the need for careful monitoring and individualized therapy COPD patients. Conclusions: Optimal care requires a multidisciplinary, patient-centred approach integrating pulmonology, endocrinology, primary care, nutrition, and rehabilitation, alongside shared decision-making and patient education. Despite promising findings, critical knowledge gaps remain. Large, well-designed randomized controlled trials and standardized definitions are needed to guide personalized therapeutic strategies. Full article
(This article belongs to the Special Issue Advances in the Personalized Management of Chronic Obstructive Pulmonary Disease (COPD))
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