Exacerbations: etiology and pathophysiologic mechanisms

Chest. 2002 May;121(5 Suppl):136S-141S. doi: 10.1378/chest.121.5_suppl.136s.


Some patients with COPD are prone to frequent exacerbations, which are an important determinant of health status. Such patients have elevated airway cytokine levels, suggesting the presence of increased inflammation that may increase their susceptibility to exacerbation. The inflammatory response during a COPD exacerbation is variable, but increases in interleukin-6 levels during the exacerbation are related to the presence of a common cold. Rhinovirus infection is the most important etiologic factor in COPD exacerbations and is an important target for preventive therapy. The reduction of COPD exacerbations will have an important impact on the considerable morbidity and mortality associated with COPD.

Publication types

  • Review

MeSH terms

  • Endothelin-1 / metabolism
  • Environmental Pollution / adverse effects
  • Humans
  • Inflammation / physiopathology
  • Interleukin-6 / metabolism
  • Interleukin-8 / metabolism
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / immunology*
  • Respiratory Tract Infections / complications
  • Respiratory Tract Infections / microbiology
  • Respiratory Tract Infections / virology


  • Endothelin-1
  • Interleukin-6
  • Interleukin-8