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Medicina
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Latest Advances in Asthma and COPD
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Latest Advances in Asthma and COPD

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 4089

Special Issue Editors

Dr. Stefania Principe

E-Mail Website
Guest Editor
Department of Respiratory Medicine—Amsterdam, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
Interests: asthma; chronic obstructive pulmonary disease
Prof. Dr. Nicola Scichilone

E-Mail Website
Guest Editor
Department of Pulmonology, AOUP Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy
Interests: asthma; chronic obstructive pulmonary disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Asthma and chronic obstructive pulmonary disease (COPD) are two of the most prevalent respiratory diseases globally, affecting millions of people and posing significant healthcare challenges. They are complex respiratory conditions with many aspects that are not yet fully understood. This Special Issue aims to showcase the most recent developments in the understanding, management, and treatment of these conditions. We invite researchers to contribute their original research, reviews, and systematic reviews to improving the quality of the management of patients affected by asthma and COPD.

Topics of Interest: We welcome submissions on a broad range of topics related to asthma and COPD, including but not limited to:

  1. Advances in diagnostic techniques;
  2. Innovative therapies;
  3. Personalized medicine approaches;
  4. Epidemiology and public health;
  5. Emerging Technologies.

Dr. Stefania Principe
Prof. Dr. Nicola Scichilone
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 100 words) can be sent to the Editorial Office for announcement on this website.

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • asthma
  • COPD
  • disease mechanisms
  • precision medicine
  • epidemiology
  • technologies

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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14 pages, 416 KB  
Article
Healthcare Workers (HCWs)’ Perceptions and Current Practice of Managing Cognitively Impaired Patients with Chronic Obstructive Pulmonary Disease (COPD)
by Rayan A. Siraj
Medicina 2025, 61(1), 59; https://doi.org/10.3390/medicina61010059 - 2 Jan 2025
Viewed by 1163
Abstract
Background and Objectives: Despite the significant impacts of cognitive impairment on patients with chronic obstructive pulmonary disease (COPD), there is limited information available on healthcare workers’ (HCWs) perceptions, current practice, and barriers to managing COPD patients with cognitive impairment. Materials and Methods [...] Read more.
Background and Objectives: Despite the significant impacts of cognitive impairment on patients with chronic obstructive pulmonary disease (COPD), there is limited information available on healthcare workers’ (HCWs) perceptions, current practice, and barriers to managing COPD patients with cognitive impairment. Materials and Methods: A cross-sectional questionnaire was distributed to HCWs in Saudi Arabia between April and December 2023. The collected responses were analysed using descriptive statistics and logistic regression models. Results: A total of 890 participants, including nursing, physical, and respiratory therapists, completed the online questionnaire. Over two-thirds of the study participants indicated not having sufficient knowledge or adequate training in managing cognitive impairment in patients with COPD. The majority of HCWs perceive cognitive impairment to underdiagnose COPD (83%), underestimate COPD severity (81%), exacerbate COPD symptoms (80%), and interfere with self-management (81%) and pulmonary rehabilitation (81%). However, less than 45% (n = 394) reported having the potential to recognise signs of cognitive impairment during patient encounters. Logistic regression analysis revealed that male healthcare practitioners were more likely to recognise cognitive impairment than females (OR: 1.48; 95% CI: 1.13 to 1.95; p < 0.001). Physical and respiratory therapists were more likely to identify cognitive impairment compared to nurses. Additionally, having more years of experience (≥10 years, OR: 1.63; 95% CI: 1.02 to 2.61; p = 0.001) and adequate knowledge of cognitive impairment (OR: 6.23; 95% CI: 4.18 to 9.29; p = 0.001) were strongly associated with better recognition. Confidence in managing cognitively impaired COPD patients was low, attributed to poor training (64%), inadequate knowledge (64%), and the absence of standardised procedures (58%). Conclusions: HCWs agreed upon the negative impacts associated with cognitive impairment in patients with COPD. However, the potential of recognising signs of cognitive impairment and confidently dealing with the existence of cognitive impairment in COPD is not optimal, owing to poor training and limited knowledge. A focus should be given to managing comorbidities alongside COPD. Full article
(This article belongs to the Special Issue Latest Advances in Asthma and COPD)
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9 pages, 586 KB  
Article
Elevated Urotensin-II and TGF-β Levels in COPD: Biomarkers of Fibrosis and Airway Remodeling in Smokers
by Metin Kilinc, Ibrahim Demir, Semih Aydemir, Rauf Gul and Recep Dokuyucu
Medicina 2024, 60(11), 1750; https://doi.org/10.3390/medicina60111750 - 24 Oct 2024
Cited by 3 | Viewed by 1677
Abstract
Background and Objectives: Small airway fibrosis plays a critical role in the progression of chronic obstructive pulmonary disease (COPD). Previous research has suggested that Urotensin-II (U-II) and transforming growth factor-β (TGF-β) may contribute to pathological fibrosis in various organs, including the cardiovascular system, lungs, [...] Read more.
Background and Objectives: Small airway fibrosis plays a critical role in the progression of chronic obstructive pulmonary disease (COPD). Previous research has suggested that Urotensin-II (U-II) and transforming growth factor-β (TGF-β) may contribute to pathological fibrosis in various organs, including the cardiovascular system, lungs, and liver. However, their specific relationship with airway fibrosis in COPD has not yet been thoroughly investigated. This study aims to evaluate the concentrations of U-II and TGF-β in individuals with COPD, as well as in healthy smokers and non-smokers, to explore their potential roles in COPD-related fibrosis. Materials and Methods: The study included three distinct groups: a healthy non-smoker control group (n = 98), a healthy smoker group (n = 78), and a COPD group (n = 80). All participants in the COPD group had a smoking history of at least 10 pack-years. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, with only patients classified as GOLD stage 2 or higher being included in the study. Urotensin-II (U-II) and transforming growth factor-β (TGF-β) levels were measured using a commercially available ELISA kit. Results: COPD patients had a significantly lower FEV1 (58 ± 15.4%) compared to smokers (79 ± 4.5%) and non-smokers (92 ± 3.7%) (p < 0.001). Similarly, COPD patients had a lower FEV1/FVC ratio (55 ± 9.4%) compared to smokers (72 ± 4.2%) and non-smokers (85 ± 3.6%) (p < 0.01 and p < 0.05, respectively). SaO2 was significantly lower in COPD patients (87%) compared to smokers (96.5%) and non-smokers (98%) (COPD vs. smokers: p < 0.05 and smokers vs. non-smokers: p > 0.05). U-II levels were significantly higher in COPD patients (175.10 ± 62.40 pg/mL) compared to smokers (118.50 ± 45.51 pg/mL) and non-smokers (85.29 ± 35.87 pg/mL) (p < 0.001 and p < 0.05, respectively). COPD patients also had significantly higher levels of TGF-β (284.60 ± 60.50 pg/mL) compared to smokers (160.00 ± 41.80 pg/mL) and non-smokers (92.00 ± 25.00 pg/mL) (p < 0.001 and p < 0.05, respectively). Conclusions: Our study supports the growing body of evidence that U-II and TGF-β play central roles in the development and progression of fibrosis in COPD. The negative correlation between these markers and lung function parameters such as FEV1 and FEV1/FVC indicates that they may be key drivers of airway remodeling and obstruction. These biomarkers could serve as early indicators of fibrotic changes in smokers, even before the onset of COPD. Full article
(This article belongs to the Special Issue Latest Advances in Asthma and COPD)
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Review

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25 pages, 1564 KB  
Review
COPD and Comorbid Mental Health: Addressing Anxiety, and Depression, and Their Clinical Management
by Rayan A. Siraj
Medicina 2025, 61(8), 1426; https://doi.org/10.3390/medicina61081426 - 7 Aug 2025
Viewed by 701
Abstract
Anxiety and depression are common comorbidities in patients with chronic obstructive pulmonary disease (COPD), which can contribute to increased morbidity, reduced quality of life, and worse clinical outcomes. Nevertheless, these psychological conditions remain largely overlooked. This narrative review includes studies published between 1983 [...] Read more.
Anxiety and depression are common comorbidities in patients with chronic obstructive pulmonary disease (COPD), which can contribute to increased morbidity, reduced quality of life, and worse clinical outcomes. Nevertheless, these psychological conditions remain largely overlooked. This narrative review includes studies published between 1983 and 2025 to synthesise the current evidence on the risk factors, clinical impacts, and therapeutic strategies for these comorbidities. While the exact mechanisms leading to their increased prevalence are not fully understood, growing evidence implicates a combination of biological (e.g., systemic inflammation), social (e.g., isolation and stigma), and behavioural (e.g., smoking and inactivity) factors. Despite current guidelines recommending the identification and management of these comorbidities in COPD, they are not currently included in COPD assessments. Undetected and unmanaged anxiety and depression have serious consequences, including poor self-management, non-adherence to medications, increased risk of exacerbation and hospitalisations, and even mortality; thus, there is a need to incorporate screening as part of COPD assessments. There is robust evidence showing that pulmonary rehabilitation, a core non-pharmacological intervention, can improve mood symptoms, enhance functional capacity, and foster psychosocial resilience. Psychological therapies such as cognitive behavioural therapy (CBT), mindfulness-based approaches, and supportive counselling have also demonstrated value in reducing emotional distress and improving coping mechanisms. Pharmacological therapies, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed in moderate to severe cases or when non-pharmacological approaches prove inadequate. However, the evidence for their efficacy in COPD populations is mixed, with concerns about adverse respiratory outcomes and high discontinuation rates due to side effects. There are also barriers to optimal care, including underdiagnosis, a lack of screening protocols, limited provider training, stigma, and fragmented multidisciplinary coordination. A multidisciplinary, biopsychosocial approach is essential to ensure early identification, integrated care, and improved outcomes for patients with COPD. Full article
(This article belongs to the Special Issue Latest Advances in Asthma and COPD)
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