Although COPD is a major disease world-wide, there is a perplexing
current uncertainty about the nature of this disease. COPD is
characterised at onset and prevalently by the involvement of the
lungs and bronchi, but as the disease evolves, abnormalities
develop in other organs and systems and the question arises: what
is the pathogenesis of these respiratory and systemic impairments?
Are the alterations that occur outside the respiratory system in
the course of COPD a direct consequence of the lung pathology or is
the lung simply the local expression of a pathological event whose
origin lies in the organism as a whole? There is currently a
growing debate about whether COPD and all its comorbidities should
be considered as a pulmonary disease with systemic implications or
whether it should come under a new umbrella term -- chronic
systemic inflammatory syndrome -- because the systemic effects of
smoking contribute to several other conditions, including
cardiovascular disease, some cancers, and increased blood pressure.
General
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