Pathology

• Chronic obstructive pulmonary disease (COPD) comprises pathological changes in four different compartments of the lungs (central airways, peripheral airways, lung parenchyma, pulmonary vasculature), which are variably present in individuals with the disease.
  • See CENTRAL AIRWAYS.
  • See PERIPHERAL AIRWAYS.
  • See LUNG PARENCHYMA.
  • See PULMONARY VASCULATURE.

Pathogenesis

• Tobacco smoking is the main risk factor for COPD, although other inhaled noxious particles and gases may contribute. This causes an inflammatory response in the lungs, which is exaggerated in some smokers, and leads to the characteristic pathological lesions of COPD. In addition to inflammation, an imbalance of proteinases and antiproteinases in the lungs, and oxidative stress are also important in the pathogenesis of COPD.
  • See INFLAMMATION.
  • See PROTEINASE AND ANTIPROTEASE IMBALANCE.
  • See OXIDATIVE STRESS.

Pathophysiology

• The different pathogenic mechanisms produce the pathological changes which, in turn, give rise to the physiological abnormalities in COPD: mucous hypersecretion and cilliary dysfunction, airflow limitation and hyperinflation, gas exchange abnormalities, pulmonary hypertension, and systemic effects.
  • See MUCOUS HYPERSECRETION AND CILLIARY DYSFUNCTION.
  • See AIRFLOW LIMITATION AND HYPERINFLATION.
  • See GAS EXCHANGE ABNORMALITIES.
  • See PULMONARY HYPERTENSION.
  • See SYSTEMIC EFFECTS.