The Asian Network for Obstructive Lung Disease (ANOLD)-COPD from an Asian perspective

A poorly reversible and chronic airflow obstruction is the cardinal feature of chronic obstructive pulmonary disease (COPD). However, the condition is heterogeneous in many other ways. Our vigorous attempt to phenotype or endotype COPD testifies this fact. It is not the disease entity mechanism alone but its interaction with a whole host of socio-environmental factors that have created the kind of COPD burden we see today. Some years ago, Tan et al . highlighted that there were more deaths and disability suffered in COPD in Asia region than developed western countries1 and showed high and varied trends of hospital admissions and mortality in the various Asia countries.2 The emphasis was on confronting the high smoking prevalence in Asia as well as optimal deployment of health care resources. The picture is obviously larger than this. In Burden of Obstructive Lung Disease (BOLD) analysis of 22 study sites (including those in Asia), Burney et al. 3 showed that poverty, not cigarette consumption, has greater association with lung function restriction that correlates significantly with COPD mortality. This finding thrusts forward poverty as a bigger threat than does cigarette smoking in COPD. Byrne et al. 4 showed …