Update on the pathogenetic hallmarks of chronic obstructive pulmonary disease

Chronic Obstructive Pulmonary Disease (COPD) is a major cause of global morbidity and mortality, affecting over 300 million individuals worldwide. While traditionally linked to tobacco smoking, increasing evidence highlights the contributions of genetic predisposition, early-life events, and environmental exposures to the onset and progression of the disease. COPD pathogenesis is driven by complex mechanisms that lead to small airway obstruction and alveolar destruction. This review describes key hallmarks of COPD pathogenesis, including innate immune responses, adaptive immunity with lymphoid follicle formation, type 1 and 17 inflammation versus type 2 inflammation, oxidative stress, mitochondrial dysfunction, metabolic changes, dysregulated cell death, and epigenetic alterations. A comprehensive understanding of these pathophysiological processes is essential for the development of targeted, personalized therapeutic strategies aimed at arresting disease progression and improving patient outcomes.