© 2004 BMJ Publishing Group Ltd & British Thoracic Society
EDITORIAL
HRCT scanning in COPD
The HRCT scan pursuing real life pathology
Correspondence to:
Correspondence to:
Dr R A Stockley
Department of Medicine, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK; r.a.stockley@bham.ac.uk
HRCT scanning brings a new dimension to studies of COPD
Keywords: chronic obstructive pulmonary disease; emphysema; HRCT scanning
| The first 150 words of the full text of this article appear below. |
The pathogenesis of chronic obstructive pulmonary disease (COPD) is widely considered to be the result of uncontrolled pulmonary inflammation. This is based on the original concept of a protease/antiprotease imbalance leading to peripheral tissue destruction and the development of emphysema. The premature development of emphysema in 
1-antitrypsin deficiency gave rise to this hypothesis and led to an increasing field of research in the 1970s investigating the inflammation in emphysema using bronchoalveolar lavage. In addition, a series of in vitro experiments investigated the ability of enzymes to produce emphysema-like lesions and its prevention by proteinase inhibitors.1 More recently the smoking mouse and a series of gene knock-out and transgenic animals has explored not only the role of proteinases and inflammatory cells, but also proinflammatory cytokines, adhesion molecules, and growth factors in the development of emphysema.2
The study of upper airway secretions has indicated that inflammation is also
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