Bronchial vascular remodeling in emphysema/chronic bronchitis

Chronic obstructive pulmonary disease (COPD) is global health problem with increasing morbidity and mortality (1). COPD is characterized by airflow limitation that is not fully reversible, usually progressive, and associated with an abnormal inflammatory response of the lungs following exposure to noxious particles and gases and inhaled cigarette smoke (2,3). One important pathological feature of COPD is airway inflammation, characterized by an influx of neutrophils, macrophages, and CD8+T-lymphocytes in the lumen and wall of bronchial and bronchiolar airways and parenchyma (4-6). Over time, alveolar destruction results in emphysema, and chronic bronchial inflammation leads to chronic bronchitis-which is why COPD is often called “emphysema and chronic bronchitis” (7). Interestingly, only 10% to 20% of all smokers develop symptomatic COPD; yet the causes of this variability in response of the airways and lung parenchyma to tobacco smoke exposure remain largely unclear.