Chronic obstructive pulmonary disease pathophysiology

Describe the pathophysiology of chronic obstructive pulmonary disease (COPD). 

Until now we have been discussing natural product HDAC inhibitors and their benefits for pathophysiological conditions. However, recent research shows that for treatment of a few diseased conditions, it is beneficial to increase HDAC activity. One such example is chronic obstructive pulmonary disease (COPD). 

MacNee W. Pathophysiology of cor pulmonale in chronic obstructive pulmonary disease, part 2. Am J Respir Crit Care Med 1994 150 1158-1168. 

Pathophysiologic Derat ements in the Chronic Obstructive Pulmonary Diseases and Pharmacolc ic Regulation of Airway Function... 

J.C. Hogg, Pathophysiology of airflow limitation in chronic obstructive pulmonary disease, Dancet (Dondon, England) 364 (9435) (2004 Aug 21-27) 709—721. 

Bronchial asthma is characterized by an increased responsiveness of the trachea and bronchi to various stimuli and is manifested by a widespread narrowing of the airways that changes in severity either spontaneously or as a result of therapy (91). Chronic bronchitis is defined as a condition with chronic or recurrent bronchial hypersecretion, cough and expectoration during at least 3 months for at least 2 successive years (92). Chronic bronchitis is often associated with chronic airways obstruction with minimal reversibility it is then called chronic obstructive pulmonary disease (COPD). Chronic airways obstruction in COPD is believed to be caused by either emphysema or irreversible obstructive changes in the peripheral airways, or both. There is an overlap between asthma and COPD, and many patients may have features of both diseases (93). Asthma is considered an important risk factor for the development of COPD. Bronchial hyperresponsiveness is a hallmark of asthma, whereas its importance in COPD is more obscure. Airway inflammation is a key factor for the development of bronchial hyperresponsiveness (94). Table 4 shows the main pathophysiological features of airways obstruction in asthma, chronic bronchitis, and emphysema. 

Particle clearance by cough supports mucociliary clearance, especially under pathophysiological conditions of diseased lungs (60), such as chronic obstructive pulmonary disease (COPD), immotile cilia syndrome (ICS), and cystic fibrosis (CF). An increased secretion in the airways seems to be necessary. During cough, mucus is propelled toward the larynx by the very fast exhalation, with linear air... 

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