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Abstract

Chronic obstructive pulmonary disease (COPD) is primarily an airway condition, which mainly affects cigarette smokers and presents with shortness of breath that is progressive and poorly reversible. In COPD research, there has been a long held belief that airway disease progression is due to inflammation. Although this may be true in the airway lumen with innate immunity activated by the effect of smoke or secondary to infection, the accurate picture of inflammatory cells in the airway wall, where the pathophysiological COPD remodeling occurs, is uncertain and debatable. Areas covered: The current review provides a comprehensive literature survey of the changes in the main inflammatory cells in human COPD patients and focuses on contrarian views that affect the prevailing dogma on inflammation. The review also delves into the role of oxidative stress and inflammasomes in modulating the immune response in COPD. Further, the effects of inflammation in affecting the epithelium, fibroblasts, and airway remodeling are discussed. Expert commentary: Inflammation as a driving force for airway wall damage and remodelling in early COPD is at the very least 'oversimplified' and is likely to be misleading. This has serious implications for rational thinking about the illness, including pathogenesis and designing therapy.

Item Type:	Article
Authors/Creators:	Eapen, MS and Myers, S and Walters, EH and Sohal, SS
Keywords:	COPD, ICS, inflammation, lung cancer, EMT
Journal or Publication Title:	Expert review of respiratory medicine
Publisher:	Taylor & Francis
ISSN:	1747-6348
DOI / ID Number:	https://doi.org/10.1080/17476348.2017.1360769
Copyright Information:	© 2017 Informa UK Limited
Related URLs:	UTAS Profile: Myers, S UTAS Profile: Walters, EH Google Scholar: Sohal, SS UTAS Profile: Sohal, SS
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