Research progress in early states of chronic obstructive pulmonary disease: a narrative review on PRISm, pre-COPD, young COPD and mild COPD

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) represents a significant global health burden. This review addresses the critical need for early identification and intervention by investigating the current research landscape in the early stages of the disease. AREAS COVERED: This review synthesizes the literature on the definitions, epidemiology, diagnostic approaches, prognosis, and management strategies for early COPD states, including preserved ratio impaired spirometry (PRISm), pre-COPD, young COPD, and mild COPD. A comprehensive literature search was conducted in PubMed and Web of Science up to October 2024. EXPERT OPINION: Experts believe that while conceptualizing early COPD offers transformative potential, progress is hampered by ambiguous diagnostic criteria and limitations in biomarkers. Future efforts should prioritize precision prevention through deep phenotyping and technological integration, acknowledging the risk of disparities.