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Minerva Pneumologica 2002 September;41(3):63-74

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: Italian

Structural bases of COPD

Turato G., Zuin R., Baraldo S., Beghé Bazzan E., Saetta M.

Chronic obstructive pulmonary disease (COPD) has been defined as a disease state characterised by poorly reversible airflow limitation that is usually progressive and associated with an abnormal inflammatory response of the lung. COPD is not a unique disease entity but rather a complex of conditions that contribute to airflow limitation. These conditions include emphysema and chronic bronchitis. It is likely that the mechanisms underlying the airflow limitation of such different entities are also different. Similarly the associated structural changes may be different. Currently available information suggests that cigarette smoke-induced lung inflammation has a pathogenetic role in the development of COPD. This chapter will describe the structural changes present in the lungs of smokers with normal lung function and those present in central airways, peripheral airways and lung parenchyma of smokers with COPD, underlying the possible mechanisms contributing to airflow limitation in these patients. Moreover we will discuss the structural changes that occur in COPD during an exacerbation of the disease and those that occur in severe disease. Finally, we will discuss the potential reversibility of the structural changes characteristic of COPD.