Recent advances in understanding inflammation and remodeling in the airways in chronic obstructive pulmonary disease

Expert Rev Respir Med. 2013 Jun;7(3):275-88. doi: 10.1586/ers.13.26.


The authors have reviewed the current literature on airway inflammation and remodeling in smoking-related chronic obstructive pulmonary disease (COPD). Detailed data on airway remodeling in COPD are especially sparse and how these changes lead to decline in lung function is not well understood. Small airway fibrosis and obliteration are likely to be the main contributors to physiological airway dysfunction and occur earlier than any subsequent development of emphysema. One potential mechanism contributing to small airway fibrosis/obliteration and change in extracellular matrix is epithelial-mesenchymal transition. When associated with angiogenesis (so-called epithelial-mesenchymal transition type 3) it may well also be the link with the development of cancer, which is closely associated with COPD, predominantly in large airways. The authors have focused on our recent publications in these areas. Further investigations teasing out these mechanisms will help improve our understanding of key airway disease processes in COPD, which may have major therapeutic implications.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / administration & dosage
  • Airway Remodeling* / drug effects
  • Animals
  • Disease Progression
  • Epithelial-Mesenchymal Transition
  • Extracellular Matrix / metabolism
  • Fibrosis
  • Humans
  • Inflammation Mediators / metabolism*
  • Lung* / drug effects
  • Lung* / immunology
  • Lung* / metabolism
  • Lung* / pathology
  • Lung* / physiopathology
  • Mast Cells / immunology
  • Mast Cells / metabolism
  • Mast Cells / pathology
  • Pneumonia* / drug therapy
  • Pneumonia* / epidemiology
  • Pneumonia* / immunology
  • Pneumonia* / metabolism
  • Pneumonia* / pathology
  • Pneumonia* / physiopathology
  • Pulmonary Disease, Chronic Obstructive* / drug therapy
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Pulmonary Disease, Chronic Obstructive* / immunology
  • Pulmonary Disease, Chronic Obstructive* / metabolism
  • Pulmonary Disease, Chronic Obstructive* / pathology
  • Pulmonary Disease, Chronic Obstructive* / physiopathology
  • Smoking / adverse effects


  • Adrenal Cortex Hormones
  • Inflammation Mediators