Problems in diagnosing pre-COPD (case report)

Ishchanka A.U., Hardziyevich T.H., Shchurok I.M., Siamionava I.V., Fedarchuk A.M., Zakharova V.V.

Vitebsk State Medical University, Vitebsk, Belarus
Vitebsk Regional Clinical Hospital, Belarus

Cigarette smoke is a key risk factor for developing COPD (GOLD, 2024). One of the factors responsible for tissue damage and bronchial remodeling in the early stages of the disease is patients’ hypersensitivity to nicotine and components of cigarette smoke. Because of early life adversity combined with environmental and genetic interactions, pulmonary function measures alone may not be appropriate for the early recognition and diagnosis of COPD. It seems necessary to identify biomarkers of the risk of developing pre-COPD to identify the early stage of the disease.
In the article we describe the clinical case of patient M., 21 years old, a smoker with a history of respiratory symptoms, who has signs of chronic obstructive pathology with the formation of bronchial hypersensitivity and persistent obstruction that does not reach the threshold for COPD, which reflects a common clinical problem. Сertainly, the formation of the concept of pre-COPD and the development of clinical and instrumental diagnostic criteria are necessary. Previously, we developed and tested a prick-prick test method with nicotine.
We propose to use skin testing with a nicotine solution as one of the diagnostic biomarkers to identify hypersensitivity at the first stage of tissue damage.