Pathophysiology of COPD

Pathophysiology of COPD

The most consistent pathological finding is hypertrophy and increase in number of mucus secreting goblet cells of the bronchial tree, evenly distributed through the lung but mainly seen in the large bronchi- in addition, in the more severe cases, the bronchi themselves are obviously inflamed and pus is seen in the lumen.

Microscopically there is infiltration of the walls of the bronchi and bronchioles with acute and chronic inflammatory cells and lymphoid follicles in severe disease (the lymphocyte infiltrate is predominantly CD8+). - initially when the small airways are affected, this can be reversed like in the improvement of airway function when smoking is stopped early!

As the disease increases in severity, squamous cell metaplasia arises, as well as fibrosis of the bronchial walls. These changes in turn cause developments in airflow limitation.

[metaplasia= the change in the type of adult cells in a tissue to a form abnormal for that tissue]

Reference- Kumar and Clark-Clinical medicine (pg900)

Jacqui.