On 2016 Aug 27, Santosh Kondekar commented:

It was interesting to read about pathogenesis of COPD. Its really beautifully differentiated from asthma. The concept of early child hood onset of COPD needed an extra mention. As COPD of early onset often has its roots in early childhood.An early onset COPD often has some neonatal or infantile insult that causes fixed parenchymal insult which makes the airways more susceptible for dysplasia or remodelling. As these cases are often overlooked as refractory child hood asthma; they often are mistreated; early picking up of low FEV1 and non responsiveness to steroids should compel a clinician take an appropriate step like a CT chest at early age to pick up fixed parenchymal damage or fixed airway changes. Clinically; to avoid overdiagnosis of asthma; we follow a criteria called "other than asthma" or OTA criteria; this helps us segregate cases with potential for development of COPD in future. OTA can be read at http://childasthma.weebly.com/ota-other-than-asthma-or-asthma-like-illnesses.html

On 2016 Aug 27, Santosh Kondekar commented:

It was interesting to read about pathogenesis of COPD. Its really beautifully differentiated from asthma. The concept of early child hood onset of COPD needed an extra mention. As COPD of early onset often has its roots in early childhood.An early onset COPD often has some neonatal or infantile insult that causes fixed parenchymal insult which makes the airways more susceptible for dysplasia or remodelling. As these cases are often overlooked as refractory child hood asthma; they often are mistreated; early picking up of low FEV1 and non responsiveness to steroids should compel a clinician take an appropriate step like a CT chest at early age to pick up fixed parenchymal damage or fixed airway changes. Clinically; to avoid overdiagnosis of asthma; we follow a criteria called "other than asthma" or OTA criteria; this helps us segregate cases with potential for development of COPD in future. OTA can be read at http://childasthma.weebly.com/ota-other-than-asthma-or-asthma-like-illnesses.html