[Chronic obstructive pulmonary disease: from pathogenesis to treatment].
Chronic obstructive pulmonary disease (COPD) is a chronic disease of the lungs that is characterised by a decreased air flow and an abnormal inflammatory response. Inflammation of the small airways caused by inhaled particles and gases is believed to be a major factor in the pathogenesis of chronic obstructive pulmonary disease. Oxidative stress may be an additional important pathogenetic factor and may enhance the inflammatory process. In that context a disturbance of the physiologic balance between proteases and antiproteases develops, which may cause lung emphysema. Currently it is also discussed that the loss of alveolar cells by apoptosis contributes to the development of emphysema. There is growing awareness of the systemic consequences of this disease. It has been demonstrated that markers of systemic inflammation are increased in COPD. Furthermore, cardiovascular, neurologic, psychiatric, muscoloskeletal and endocrine manifestations have been described. New therapy concepts based on these findings will hopefully result in improvements of morbidity, disease control and quality of life.
Koczulla
A R
AR
Abteilung für Pulmonologie, Universitätsklinikum Giessen und Marburg, Standort Marburg, Baldingerstrasse 1, 35042 Marburg. koczulla@uni-marburg.de
Vogelmeier
C
C
D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology* / Q000628:therapy*