Fisiopatología de la enfermedad pulmonar obstructiva crónica (EPOC): Pathophysiology of chronic obstructive pulmonary disease (COPD)

ROY FAUSTINO SANCHEZ SUYO; XIOMARA YASMIN SALDAÑA SAGASTEGUI; Genesis Aracelly Rodriguez Ancachi; RUBI YELOMILL ROSAS AGUILAR

doi:10.57188/ricsa.2026.005

Authors

ROY FAUSTINO SANCHEZ SUYO Universidad Nacional del Santa, Escuela Profesional de Medicina Humana, Chimbote, Perú https://orcid.org/0009-0006-7392-7132 (unauthenticated)
XIOMARA YASMIN SALDAÑA SAGASTEGUI Universidad Nacional del Santa, Escuela Profesional de Medicina Humana, Chimbote, Perú https://orcid.org/0009-0002-3643-9675 (unauthenticated)
Genesis Aracelly Rodriguez Ancachi Universidad Nacional del Santa, Escuela Profesional de Medicina Humana, Chimbote, Perú https://orcid.org/0000-0002-8408-3856 (unauthenticated)
RUBI YELOMILL ROSAS AGUILAR Universidad Nacional del Santa, Escuela Profesional de Medicina Humana, Chimbote, Perú https://orcid.org/0009-0001-9380-3210 (unauthenticated)

DOI:

https://doi.org/10.57188/ricsa.2026.005

Keywords:

Chronic Obstructive Pulmonary Disease; Airway Obstruction; Inflammation; Pulmonary Emphysema; Gas Exchange; Airway Remodeling. (Source: DeCS-BIREME)

Abstract

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by persistent and not fully reversible airflow limitation, resulting from a chronic inflammatory response to harmful particles, primarily tobacco smoke. Its pathophysiology involves chronic inflammation, airway remodeling, increased airway resistance, parenchymal destruction with loss of elastic recoil (emphysema), and air trapping, leading to impaired gas exchange. Additionally, COPD is associated with systemic manifestations, including diaphragmatic dysfunction and secondary pulmonary hypertension. A comprehensive understanding of these mechanisms is essential to optimize clinical management and preventive strategies, particularly in regions with limited access to healthcare services, such as northern Peru.

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References

1. World Health Organization. Chronic obstructive pulmonary disease (COPD). 2023. Disponible en: https://www.who.int/news-room/fact- sheets/detail/chronic-obstructive-pulmonary-disease-(copd)

2. Celli BR, Wedzicha JA. Update on clinical aspects of chronic obstructive pulmonary disease. N Engl J Med. 2023;388(8):728–44. doi:10.1056/NEJMra2213764

3. Guerin C, Al-Rawashdeh B, Richard JCM. Continuous monitoring of respiratory system compliance during pressure-controlled ventilation in COPD patients. Am J Respir Crit Care Med. 2024;209(3):311–9. PMID: 39754074.

4. Tonelli R, Busani S, Clini E. Mechanical power and ventilator-induced lung injury: current insights and applications. Intensive Care Med Exp. 2023;11(1):44. PMID: 39241350.

5. Pelosi P, Ball L, Gattinoni L. Time constant and alveolar ventilation: understanding regional differences in lung mechanics. Curr Opin Crit Care. 2024;30(2):119–26.

6. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2024 Report. Disponible en: https://goldcopd.org

7. Lo´pez-Campos JL, Tan W, Soriano JB. Global burden of COPD. Respirology. 2016;21(1):14–23.

8. West JB. Fisiologí´a respiratoria: fundamentos. 10ª ed. Barcelona: Wolters Kluwer; 2022.

9. Miravitlles M, Soler-Catalun˜a JJ, Calle M, Molina J, Almagro P, Quintano JA, et al. Guí´a Espan˜ola de la EPOC (GesEPOC) 2021. Arch Bronconeumol. 2021;57(1):1–11

10. Sahin G, Morales-Quinteros L, Pelosi P. Mechanical aspects of spontaneous and mechanical ventilation. Crit Care Clin. 2024;40(1):23–38. PMID: 38241900. https://www.ncbi.nlm.nih.gov/pmc/articles/PM C11019631

11. Chen Y, Yuan Y, Chang Q, Zhang H, Li F, Chen Z. Continuous estimation of respiratory system compliance and airway resistance during pressure-controlled ventilation without end- inspiration occlusion. BMC Pulm Med. el 20 de mayo de 2024;24(1):249. doi:10.1186/s12890- 024-03061-2

12. Grune J, Tabuchi A, Kuebler WM. Alveolar dynamics during mechanical ventilation in the healthy and injured lung. ICMx. julio de 2019;7(S1):34. doi:10.1186/s40635-019-0226-5

13. Bates JH, Kacz|ka DW, Kollisch-Singule M, Nieman GF, Gaver III DP. Mechanical power and ventilator- induced lung injury: what does physics have to say? American journal of respiratory and critical care medicine [Internet]. Oxford University Press; 2024 [citado el 21 de marzo de 2026]. p. 787–8. Disponible en: https://academic.oup.com/ajrccm/article- abstract/209/7/787/8427024

14. StatPearls. Physiology, Pulmonary Ventilation and Perfusion. Kyle A Powers, Amit S Dhamoon. 2023 Jan 23.

15. Open Textbook of Exercise Physiology. Chapter 7: Gas Exchange Between the Environment and Blood. 2023.

16. European Respiratory Society. The physiological basis of pulmonary gas exchange: implications for clinical interpretation of arterial blood gases. 2022.

17. Fan T. Gas Exchange in Alveoli: How Oxygen and Carbon Dioxide Are Exchanged. Int J Respir Med. 2024;9(3):207.

18. Ciumas C, Rheims S, Ryvlin P. fMRI studies evaluating central respiratory control in humans. Front Neural Circuits. 2022;16:982963.

19. Moreira TS, Mulkey DK, Takakura AC. Update on vascular control of central chemoreceptors. Exp Physiol. 2023;108(12):1590–1598.

20. Frontiers | The integrated brain network that controls respiration. Wang et al. eLife. 2022;11:e83654.

21. Goheen J, Anderson JA, Zhang J, Northoff G. From Lung to Brain: Respiration Modulates Neural and Mental Activity. Neurosci Bull. 2023;39(10):1577– 1590. PMID: 37285017.

22. Alfahad AJ, Alzaydi MM, Aldossary AM, Alshehri AA, Almughem FA, Zaidan NM, Tawfik EA. Current views in chronic obstructive pulmonary disease pathogenesis and management. Saudi Pharm J. 2021;29(11):1361–73.

23. Barnes PJ. Mecanismos inflamatorios en pacientes con enfermedad pulmonar obstructiva cro´nica. J Alergia Clin Immunol. (2016) 138:16–27. doi: 10.1016/j.jaci.2016.05.011

24. Polosukhin VV, Richmond BW, Du RH, Cates JM, Wu P, Nian H, et al. La deficiencia secretora de IgA en las ví´as respiratorias pequen˜as individuales se asocia con inflamacio´n y remodelacio´n persistentes. Am J Respir Crit Care Med. (2017) 195:1010–21. doi: 10.1164/rccm.201604-

0759OC

25. Gao W, Li L, Wang Y, Zhang S, Adcock IM, Barnes PJ, Huang M, Yao X. Bronchial epithelial cells: The key effector cells in the pathogenesis of chronic obstructive pulmonary disease? Respirology. 2015;20(5):722-729. doi:10.1111/resp.12542.

26. Kanazawa H, Tochino Y, Asai K, Hirata K. Simultaneous assessment of hepatocyte growth factor and vascular endothelial growth factor in epithelial lining fluid from patients with COPD. Chest. 2014;146(5):1159-1165. doi:10.1378/chest.14-0373.

27. Barnes PJ. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol. 2016;138(1):16-27. doi:10.1016/j.jaci.2016.05.011.

28. Burgel P-R. Roles of epidermal growth factor receptor activation in epithelial cell repair and mucin production in airway epithelium. Thorax. 2004;59(11):992-996. doi:10.1136/thx.2003.018879.

29. Hikichi M, Mizumura K, Maruoka S, Gon Y. Pathogenesis of chronic obstructive pulmonary disease (COPD) induced by cigarette smoke. J Thorac Dis. 2019;11(Suppl 17):S2129–S2140.

30. Rodrigues SdO, Cunha CMCd, Soares GMV, Silva PL, Silva AR, Gonçalves-de-Albuquerque CF. Mechanisms, Pathophysiology and Currently Proposed Treatments of Chronic Obstructive Pulmonary Disease. Pharmaceuticals. 2021;14(10):979.

31. Walters EH, Shukla SD, Mahmood MQ, Ward C. Fully integrating pathophysiological insights in COPD: an updated working disease model to broaden therapeutic vision. Eur Respir Rev. 2021

32. Bruno CM, Valenti M. Acid-Base Disorders in Patients with Chronic Obstructive Pulmonary Disease: A Pathophysiological Review. J Biomed Biotechnol. 2012;2012:915150.

Pathophysiology of chronic obstructive pulmonary disease (COPD)