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3274018 
Journal Article 
Review 
The Pathology of Chronic Obstructive Pulmonary Disease 
Hogg, JC; Timens, Wim 
2009 
Yes 
Annual Review of Pathology: Mechanisms of Disease
ISSN: 1553-4006 
Annual Review of Pathology-Mechanisms of Disease 
4 
435-459 
English 
18954287 
WOS:000268071700018 
The pathogenesis of chronic obstructive pulmonary disease (COPD) is based on the innate and adaptive inflammatory immune response to the inhalation of toxic particles and gases. Although tobacco smoking is the primary cause of this inhalation injury, many other environmental and occupational exposures contribute to the pathology of COPD. The immune inflammatory changes associated with COPD are linked to a tissue-repair and -remodeling process that increases mucus production and causes emphysematous destruction of the gas-exchanging surface of the lung. The common form of emphysema observed in smokers begins in the respiratory bronchioles near the thickened and narrowed small bronchioles that become the major site of obstruction in COPD. The mechanism(s) that allow small airways to thicken in such close proximity to lung tissue undergoing emphysematous destruction remains a puzzle that needs to be solved. 
emphysema; remodeling; smoking; tissue repair