Document Detail


Update on the roles of distal airways in COPD.
MedLine Citation:
PMID:  21357888     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This review is the summary of a workshop on the role of distal airways in chronic obstructive pulmonary disease (COPD), which took place in 2009 in Vence, France. The evidence showing inflammation and remodelling in distal airways and the possible involvement of these in the pathobiology, physiology, clinical manifestations and natural history of COPD were examined. The usefulness and limitations of physiological tests and imaging techniques for assessing distal airways abnormalities were evaluated. Ex vivo studies in isolated lungs and invasive measurements of airway resistance in living individuals have revealed that distal airways represent the main site of airflow limitation in COPD. Structural changes in small conducting airways, including increased wall thickness and obstruction by muco-inflammatory exudates, and emphysema (resulting in premature airway closure), were important determinants of airflow limitation. Infiltration of small conducting airways by phagocytes (macrophages and neutrophils), dendritic cells and T and B lymphocytes increased with airflow limitation. Distal airways abnormalities were associated with patient-related outcomes (e.g. dyspnoea and reduced health-related quality of life) and with the natural history of the disease, as reflected by lung function decline and mortality. These data provide a clear rationale for targeting distal airways in COPD.
Authors:
P-R Burgel; A Bourdin; P Chanez; F Chabot; A Chaouat; T Chinet; J de Blic; P Devillier; A Deschildre; A Didier; G Garcia; G Jebrak; F Laurent; H Morel; T Perez; C Pilette; N Roche; I Tillie-Leblond; S Verbanck; D Dusser
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European respiratory review : an official journal of the European Respiratory Society     Volume:  20     ISSN:  1600-0617     ISO Abbreviation:  Eur Respir Rev     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-01     Completed Date:  2011-06-20     Revised Date:  2012-01-10    
Medline Journal Info:
Nlm Unique ID:  9111391     Medline TA:  Eur Respir Rev     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  7-22     Citation Subset:  IM    
Affiliation:
Service de Pneumologie, Hôpital Cochin, 27 rue du Faubourg St Jacques, Université Paris Descartes, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Airway Remodeling*
Airway Resistance*
Congresses as Topic
Diagnostic Imaging
Humans
Lung / immunology,  pathology,  physiopathology*
Predictive Value of Tests
Pulmonary Disease, Chronic Obstructive / diagnosis,  immunology,  pathology,  physiopathology*
Respiratory Function Tests
Comments/Corrections
Erratum In:
Eur Respir Rev. 2011 Jun;20(120):123

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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