Airway Inflammation in COPD*

Inflammation of the airways has been regarded as a cardinal pathophysiologic feature of asthma for some 20 years. This concept has been based on evidence from a variety of sources: the histologic changes in the airway wall, hyperresponsiveness of the asthmatic airways to a wide range of natural and pharmacologic agents, the presence of activated inflammatory and immune cells and their mediators in the airway tissues, and the fact that anti-inflammatory agents provide the best therapy in long-term control of asthma. The question whether airways inflammation is also present to a clinically important extent in COPD is still open, but is relevant because if it is, anti-inflammatory treatment would need to be considered in this condition also. I will briefly review the evidence on airway inflammation in COPD, using the same criteria but with particular reference to the role of corticosteroids.