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      The pathology of chronic obstructive pulmonary disease.

      1 ,
      Annual review of pathology
      Annual Reviews

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          Abstract

          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.

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          Author and article information

          Journal
          Annu Rev Pathol
          Annual review of pathology
          Annual Reviews
          1553-4014
          1553-4006
          2009
          : 4
          Affiliations
          [1 ] Department of Pathology and Laboratory Medicine, University of British Columbia and iCapture Center, St. Paul's Hospital, Vancouver, BC, Canada. jhogg@mrl.ubc.ca
          Article
          10.1146/annurev.pathol.4.110807.092145
          18954287
          3ef03165-db9f-478b-83a5-08caacf2d250
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