{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T08:33:31Z","timestamp":1793349211953,"version":"4.5.0"},"reference-count":55,"publisher":"The Ewha Medical Journal, Ewha Womans University College of Medicine","issue":"2","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-emj.org"],"crossmark-restriction":true},"short-container-title":["Ewha Med J"],"published-print":{"date-parts":[[2025,4,30]]},"abstract":"<jats:p>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\u2014manifested 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.<\/jats:p>","DOI":"10.12771\/emj.2025.00059","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T08:30:32Z","timestamp":1742891432000},"page":"e24","update-policy":"https:\/\/doi.org\/10.12771\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Pathophysiology, clinical manifestation, and treatment of tuberculosis-associated chronic obstructive pulmonary disease: a narrative review"],"prefix":"10.12771","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6298-2204","authenticated-orcid":true,"given":"Joon Young","family":"Choi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4998","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2023.0100"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2022.0020"},{"key":"ref3","volume-title":"","year":"2024"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2023.0194"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1080\/15412555.2022.2053088"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2024.107679"},{"key":"ref7","volume-title":"","year":"2024"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1159\/000512531"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1159\/000350917"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02325-2014"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.21037\/atm-20-4576"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000002771"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0217289"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-216500"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S475451"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2021.02.107"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2023.0197"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2024.0018"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2022.0111"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1111\/resp.14007"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-194"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000001026"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2012-203175"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202001-0165ED"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.20.0067"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1146571"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2018.02603"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000938"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.3390\/biom12081148"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.619077"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00015411"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202402-0374SO"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201311-2106PP"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-017-0663-1"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.3390\/ijms241411385"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.chom.2017.09.003"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1002\/smll.201402859"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.12.0351"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.08.29"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1086\/444545"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2021-218345"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2023.395"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.18.0722"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2019-213808"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2021-217190"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2024.39.e105"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1111\/resp.13147"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S152447"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S177371"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-1225"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S128750"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2018.0050"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S194324"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-019-1055-5"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202301-0094ED"}],"container-title":["Ewha Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-emj.org\/upload\/pdf\/emj-2025-00059.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-emj.org\/journal\/view.php?doi=10.12771\/emj.2025.00059","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-emj.org\/upload\/pdf\/emj-2025-00059.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T07:43:23Z","timestamp":1745826203000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-emj.org\/journal\/view.php?doi=10.12771\/emj.2025.00059"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,30]]},"references-count":55,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.12771\/emj.2025.00059","relation":{},"ISSN":["2234-3180","2234-2591"],"issn-type":[{"value":"2234-3180","type":"print"},{"value":"2234-2591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,30]]},"assertion":[{"value":"2025-02-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-19","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-30","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}