Chronic obstructive pulmonary disease: histopathology, inflammation and potential therapies

Chronic obstructive pulmonary disease (COPD) is a major worldwide health burden with increasing morbidity, mortality and health care cost. It is a slowly progressive chronic inflammatory condition that affects the conducting airways (both large and small) and lung parenchyma. In COPD, inflammation is evident early on even in mild disease and increases with disease severity. Recent advances in our knowledge demonstrate, by comparison with asthma, the distinctive, "abnormal" or exaggerated inflammatory processes involved in the pathogenesis of COPD and thus identify novel therapeutic targets that could potentially impact on disease progression. The present review will focus on what is known of the abnormal inflammatory response of COPD in different regions of the conducting airways and lung. Novel, potentially promising approaches to therapy are presented.