Some individuals with airflow obstruction later show normalized spirometric values, but the clinical implications of this phenomenon in the general population are unclear.

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with one of the leading causes of global morbidity and mortality. Its core pathological features include irreversible airflow limitation, chronic airway inflammation, and lung tissue remodeling. In recent years, the key roles of the Wnt signaling pathway and non-coding RNAs (ncRNAs) in the pathogenesis of COPD have gained increasing attention. As a pivotal signaling cascade governing cell proliferation, differentiation and tissue repair, the Wnt pathway undergoes aberrant activation or suppression in COPD, linking closely to airway inflammation, alveolar epithelial damage and pulmonary fibrosis. Non-coding RNAs including miRNAs, lncRNAs and circRNAs modulate COPD pathogenesis via targeting core molecules of the Wnt pathway. This review summarizes the basic components and functions of the Wnt pathway and the classification and biological roles of ncRNAs and discusses their interactive mechanisms and therapeutic strategies in COPD. In addition, this review discusses the current controversies and future directions. Studies indicate that the synergistic regulatory network between the Wnt pathway and ncRNAs provides new molecular targets for the early diagnosis, prognosis assessment, and targeted therapy of COPD, highlighting potential avenues for future therapeutic development.