Chronic Obstructive Pulmonary Disease: Cellular and Molecular Mechanisms PDF

Preface

Chronic obstructive pulmonary disease (COPD) is now recognized to be a serious chronic disease of global proportions that appears to be increasing throughout the world as the world population ages and as developing countries smoke more cigarettes. The reduction in smoking (smoking being by far the most important cause of COPD) has been less than impressive despite government restrictions, taxes, and health warnings. COPD is now one of the most common causes of death and chronic disability in the world, and is the only common cause of death that is increasing in developed countries.

Yet COPD receives little attention from doctors, patients, the media, or the pharmaceutical companies as it is often seen as irreversible and self-inflicted. It is poorly diagnosed and undertreated, or managed like asthma, which is inappropriate. This means that there is far less funding devoted to research in COPD than other common inflammatory diseases, such as asthma and rheumatoid arthritis. This is now beginning to change as it is recognized that chronic lung inflammation is an important component of COPD, which may underlie the relentless progression of the disease in most patients. No currently available drug treatment has been shown to reduce the progression of the disease or the inflammatory process. In particular corticosteroids appear to be remarkably ineffective, compared to their striking efficacy in asthma, which is now easily controlled in most patients. This suggests that there is an urgent need to understand more about the underlying cellular and molecular mechanisms involved in COPD, particularly if we are to develop more effective therapies in the future. This will involve considerable injection of research money. The disease is prevalent and the cause is usually known, giving important advantage to researchers in this field.

This volume brings together the world experts on the underlying mechanisms of COPD. This is a rapidly advancing field, but the current chapters provide an up-to-date perspective of the inflammatory cells, mediators, and molecular pathology of COPD in a single volume. I hope that the inclusion of this volume in the series will make up for some of the lack of information about the cellular and molecular mechanisms in COPD. This is an exciting time for COPD research as there have been major advances in understanding cellular mechanisms, cell signaling and gene expression relevant to COPD. Many novel types of drugs are now in development and it is very likely that some of the new approaches will bear fruit and help control and prevent the progression of this devastating disease.

I would like to thank Sandra Beberman of Taylor and Francis Books for her invaluable help and advice, and Claude Lenfant for his encouragement in preparing this volume.