Chronic obstructive pulmonary disease is a group of conditions characterised by the presence of persistent airflow obstruction during expiration, primarily owing to narrowing of the smaller airways. Its prevalence is increasing and soon it will be the third most common cause of illness and death worldwide. The condition is a slowly progressive one punctuated by acute episodes of deterioration (exacerbations) and there is currently no specific therapy confirmed to slow the progression. The underlying pathophysiology is believed to be uncontrolled inflammation owing to a combination of genetic and environmental factors. Although classically associated with smoking, increasing pollution in the industrialised world and the burning of biomass fuels indoors in the third world also influences its prevalence.

Key Concepts:

COPD is a group of conditions in which airflow obstruction cannot be fully reversed.

The pathophysiology is owing to uncontrolled inflammation in the lung.

COPD is associated with an increased risk of co-morbidities such as arteriosclerosis, type II diabetes and osteoporosis probably as a result of common inflammatory processes.

Thoracic imaging is being increasingly used to identify different pathological processes that contribute to COPD.

Large clinical trials of inhaled therapy have demonstrated a reduction in the number of acute episodes of deterioration and possibly mortality.

Keywords:

lung disease;

bronchitis;

emphysema;

COPD;

α1-antitrypsin;

smoking