COPD is a disease characterized by
inflammation both in its stable phase and during exacerbations.
Inflammation is present in the respiratory compartment, the inflammatory cells and different
mediators of inflammation being present. Studies have shown that some
mediators of inflammation have a high level at systemic level also, inducing a certain grade of systemic
inflammation, mainly responsible for the systemic manifestation of the disease. It seems that the both local and the systemic
inflammation are amplified during exacerbations. The purpose of this paper is to review the respiratory inflammatory reaction, to identify the main actors involved in the stable phase of the disease and during exacerbations, the systemic
inflammation accompanying the local
inflammation, and to find the possible interrelations between the systemic and local
inflammation, on one hand, and the respiratory and extra-respiratory manifestations of
COPD on the other hand. The understanding of the pathogenic mechanisms, which stay at the base of
inflammation and of the possible interrelations shown, represents a theoretical interest and also a practical one, concerning the targets of different therapeutic agents which could be used in the management and in the control of the disease.