Abstract
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable heterogeneous lung disease characterized by chronic respiratory symptoms such as dyspnea, cough, sputum production. The main pathophysiological changes occur in the airways, lung parenchyma, pulmonary blood vessels and are represented by chronic inflammation and structural changes. The inflammatory response is initiated by exposure to chronic irritants and amplifies with the severity of airflow. Smoking remains the most important risk factor, but chronic airflow limitation can also be objectified in non-smokers. Oxidative stress, the excess of pulmonary proteinases, the alteration of the lung microbiome and the presence of inflammatory mediators can contribute to the amplification of the inflammatory process. Lung inflammation that develops in patients with COPD leads to an increase in biomarkers that are associated with neutrophilic inflammation, such as MMP9, elastase, neutrophils in the bronchoalveolar lavage fluid, and proinflammatory cytokines in peripheral blood. Also, interleukin-8 (IL-8) contributes to neutrophil activation, but further research is needed to identify the role of IL-8, the benefits of anti-inflammatory therapy, also emphasizing the importance of progression in medicine.