OVERVIEW OF CAUSES OF COPD New understanding of pathogenesis and mechanisms can guide future therapy Evolving knowledge of causes and novel approaches to treatment promise a brighter future for patients with severe breathing impairment.

Recent studies have greatly expanded the understanding of pathogenetic mechanisms underlying COPD. Although cigarette smoking is the most important cause, various active proteases and oxidants are believed to play crucial roles as well. In this article, Dr Rennard discusses mediators that drive these processes and the systemic effects that contribute to the syndromes characteristic of COPD. He also discusses how understanding these mechanisms has created novel therapeutic approaches to management of this disorder.