Evolving concepts in the pathogenesis of chronic obstructive pulmonary disease

The study of the pathogenesis of chronic obstructive pulmonary disease (COPD) has a rich history in the pulmonary community and has led to significant understanding of elastases, extracellular matrix, and inflammation in the lung. Nevertheless, there remains little to offer patients with COPD. Fortunately, the revolution in molecular biology has allowed the re-examination and the extension of knowledge of these concepts. This article discusses the molecular response of the lung to cigarette smoke, ranging from inflammation to proteinase-release lung destruction, and impaired repair of lung structures.