Journal
ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE
Volume 4, Issue -, Pages 435-459Publisher
ANNUAL REVIEWS
DOI: 10.1146/annurev.pathol.4.110807.092145
Keywords
emphysema; remodeling; smoking; tissue repair
Categories
Funding
- Canadian Institutes of Health Research
- National Heart, Lung, and Blood Institute
- Netherlands Asthma Foundation
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The pathogenesis of chronic obstructive pulmonary disease (COPD) is based on the innate and adaptive inflammatory immune response to the inhalation of toxic particles and gases. Although tobacco smoking is the primary cause of this inhalation injury, many other environmental and occupational exposures contribute to the pathology of COPD. The immune inflammatory changes associated with COPD are linked to a tissue-repair and -remodeling process that increases mucus production and causes emphysematous destruction of the gas-exchanging surface of the lung. The common form of emphysema observed in smokers begins in the respiratory bronchioles near the thickened and narrowed small bronchioles that become the major site of obstruction in COPD. The mechanism(s) that allow small airways to thicken in such close proximity to lung tissue undergoing emphysematous destruction remains a puzzle that needs to be solved.
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