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New concepts in chronic obstructive pulmonary disease.
1National Heart and Lung Institute, Imperial College School of Medicine, Dovehouse Street, London, United Kingdom. p.j.barnes@ic.ac.uk
Annual Review of Medicine
|October 3, 2002
Summary
Chronic obstructive pulmonary disease (COPD) involves chronic inflammation, airway narrowing, and lung destruction. Current treatments are limited as COPD inflammation resists corticosteroids, necessitating new anti-inflammatory therapies.
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Area of Science:
- Pulmonary Medicine
- Cellular Biology
- Molecular Biology
Background:
- Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity.
- Recent research explores COPD's cellular and molecular underpinnings.
- COPD pathogenesis involves chronic inflammation, leading to airway obstruction and emphysema.
Purpose of the Study:
- To detail the cellular and molecular mechanisms driving COPD.
- To highlight the inflammatory and proteolytic processes in COPD.
- To underscore the resistance of COPD inflammation to corticosteroids.
Main Methods:
- Review of cellular and molecular findings in COPD.
- Analysis of inflammatory cell and mediator involvement.
- Examination of oxidative stress and matrix metalloproteinase roles.
Main Results:
- COPD features increased macrophages, neutrophils, and T lymphocytes.
- Elevated inflammatory mediators, oxidative stress, and elastolysis are observed.
- COPD inflammation is a heightened response to cigarette smoke, unlike asthma.
Conclusions:
- COPD involves complex cellular and molecular inflammatory pathways.
- The corticosteroid resistance of COPD inflammation necessitates novel therapeutic strategies.
- Further research into anti-inflammatory therapies is crucial to halt COPD progression.