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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Vnitřní lékařství, 50, 2004, č. 9, s. 663 - 667 |
Pathogenesis of the Chronic Obstructive Pulmonary Disease (COPD) Musil J. Pneumologická klinika 2. lékařské fakulty UK a FN Motol, Praha, přednosta doc. MUDr. Jaromír Musil |
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Summary: An inflammation in the bronchial wall is usually present already in an early stage of the disease.
An inflammatory infiltration cause predominantly mononuclear cells in the mucous membrane
and neutrophiles in the phlegm produced by airways. Also eosinophiles can participate in the
inflammation. Lymphocytes distribution is different from asthma because there is mainly submucosa
infiltrated in COPD. Metaplasia of goblet cells appears. Chronic bronchial obstruction characterizing
COPD is induced by conjunction of small airways disease (obstructive bronchiolitis)
and a destruction of pulmonary parenchyma (emphysema) which both contribute to an impairment
and differ form person to person. Chronic inflammation is a cause of remodeling and narrowing
of small airways. Destruction of pulmonary parenchyma and the inflammation cause loss of
alveolar connection with small airways and elastic pulmonary stress decreases. Two theories try
to explain COPD – a theory of imbalance between proteinases and antiproteinases and a theory of
oxidation stress.
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