Journal
RESPIRATORY RESEARCH
Volume 20, Issue -, Pages -Publisher
BMC
DOI: 10.1186/s12931-019-1017-y
Keywords
Bacteria; COPD; Emphysema; Exacerbations; Histopathology; Inflammation; Remodeling; Small airways disease
Categories
Funding
- North West Lung Centre Charity, Manchester
- National Institute for Health Research South Manchester Respiratory and Allergy Clinical Research Facility at University Hospital of South Manchester NHS Foundation Trust
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Small airways disease (SAD) is a cardinal feature of chronic obstructive pulmonary disease (COPD) first recognized in the nineteenth century. The diverse histopathological features associated with SAD underpin the heterogeneous nature of COPD. Our understanding of the key molecular mechanisms which drive the pathological changes are not complete. In this article we will provide a historical overview of key histopathological studies which have helped shape our understanding of SAD and discuss the hallmark features of airway remodelling, mucous plugging and inflammation. We focus on the relationship between SAD and emphysema, SAD in the early stages of COPD, and the mechanisms which cause SAD progression, including bacterial colonization and exacerbations. We discuss the need to specifically target SAD to attenuate the progression of COPD.
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