Pathology of Obstructive Airway Diseases

Pathophysiology of Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition characterized by airflow limitation and persistent respiratory symptoms. The pathophysiology involves chronic inflammation in response to harmful particles and gases, leading to airway obstruction, alveolar destruction, and mucus hypersecretion.

Key Pathological Changes

• Inflammation: Increased inflammatory cells including neutrophils, macrophages, and CD8+ T lymphocytes.
• Airway Remodeling: Thickening of the airway walls due to fibrosis and narrowing of small airways.
• Emphysema: Destruction of alveolar walls leading to air trapping and decreased gas exchange.
• Mucus Hypersecretion: Overproduction of mucus due to goblet cell hypertrophy.

Clinical Manifestations

Patients often present with chronic cough, sputum production, dyspnea, and wheezing. Exacerbations are common and can be triggered by infections or environmental pollutants.

Diagnosis and Management

• Pulmonary Function Tests (PFTs): Demonstrate irreversible airflow obstruction.
• Imaging: Chest X-ray and CT scans reveal hyperinflation and emphysematous changes.
• Pharmacological Therapy: Includes bronchodilators, corticosteroids, and oxygen therapy.
• Lifestyle Modifications: Smoking cessation and pulmonary rehabilitation are key components of management.