Airway pathology of functional significance in chronic bronchitis and chronic obstructive airway disease.

: The three major hypothesis for reduction in the calibre of the peripheral airways in chronic obstructive lung disease are 1) a loss of elastic recoil in the alveolar supporting structure, 2) destruction of the alveolar attachments to the outer wall of the small airways, and 3) a chronic inflammatory process in the wall and lumen of the peripheral airways. This presentation is based on the analysis of an ongoing study where lung function has been measured a few days prior to lung resection. The data collected to date support the third hypothesis and are of interest in developing strategies to treat patients with COAD because they suggest that therapy should be directed at preventing the inflammatory process in the peripheral airways rather than the prevention of lung destruction by emphysema.