Chronic obstructive pulmonary disease (COPD) is a chronic incurable condition of the lungs which results from years of smoking tobacco. Tobacco smoke contains many toxins which when inhaled regularly for years gradually damage the lungs and result in COPD.

The lungs are made of two main structural components, namely the airways and the interstitial or alveolar tissue. Both components are damaged by the inhalation of the cigarette smoke. The airways develop a chronic inflammation driven by the irritation from the toxins in the smoke. This chronic inflammation leads to the laying down of excessive new connective tissue in the walls of the airways, causing them to become thicker and their lumens narrower. This chronic airway inflammation and its associated changes are known as chronic bronchitis and is one of the two defining components of COPD. Chronic bronchitis causes irreversible narrowing of the airways and therefore permanently makes it more difficult to breathe. The diseased airways are also more prone to bacterial and viral infections.

The inhalation of the smoke also irritates the interstitial or alveolar tissue and results in an inflammatory response. Chronic inflammation here results over years in the destruction of the alveolar tissue. Specifically many of the alveolar walls are lost and lots of alveoli merge into one large airspace with a smaller surface area available for gas exchange. This condition of alveolar degeneration is called emphysema and it permanently damages respiratory function. It is the second of the two defining components of COPD.

In this video I describe and explain this theory of the pathogenesis of COPD and we look at how this results in the clinical symptoms the patient will experience. Towards the end of the video we also discuss something about how COPD is treated.

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