Sutherland E Rand, Martin Richard J
Department of Medicine, National Jewish Medical and Research Center and the University of Colorado Health Sciences Center, Denver, Colo, USA.
J Allergy Clin Immunol. 2003 Nov;112(5):819-27; quiz 828. doi: 10.1016/S0091.
Chronic obstructive pulmonary disease (COPD) is a progressive syndrome of expiratory airflow limitation caused by chronic inflammation of the airways and lung parenchyma. The airway inflammatory response in COPD is initiated by smoking in the overwhelming majority of cases, and chronic exposure to cigarette smoke initiates a series of events that causes damage to central airways, peripheral airways, and terminal airspaces, leading to physiologic and clinical abnormalities. Although COPD shares some clinical features with asthma, another prevalent airway inflammatory disease, there are distinct differences in the phenotypic characteristics of airway inflammation between COPD and asthma. The eosinophil is the most prominent inflammatory cell in asthma, with mast cells, lymphocytes, and macrophages playing important but less prominent roles. In COPD the cellular composition of the airway inflammatory infiltrate differs, with neutrophils, macrophages, and lymphocytes assuming prominence and the eosinophil playing a minor role, except in the setting of exacerbations. The contrasting inflammatory phenotypes of asthma and COPD have important implications for clinical and physiologic manifestations of disease, as well as for therapy.
慢性阻塞性肺疾病（COPD）是一种由气道和肺实质的慢性炎症引起的进行性呼气气流受限综合征。在绝大多数情况下，COPD中的气道炎症反应由吸烟引发，长期接触香烟烟雾会引发一系列事件，导致中央气道、外周气道和终末气腔受损，进而导致生理和临床异常。尽管COPD与另一种常见的气道炎症性疾病哮喘有一些临床特征相同，但COPD和哮喘在气道炎症的表型特征上存在明显差异。嗜酸性粒细胞是哮喘中最突出的炎症细胞，肥大细胞、淋巴细胞和巨噬细胞也发挥重要作用，但不那么突出。在COPD中，气道炎症浸润的细胞组成有所不同，中性粒细胞、巨噬细胞和淋巴细胞占主导地位，嗜酸性粒细胞起次要作用，除非在病情加重的情况下。哮喘和COPD截然不同的炎症表型对疾病的临床和生理表现以及治疗都有重要影响。
