Chronic obstructive pulmonary disease (COPD) is characterized by an airflow obstruction and is caused by a mixture of small airways disease and emphysema. Emphysema is the breakdown of alveoli and results in a reduced area for oxygen transfer. ‘Small airways disease’ is the narrowing of the small airways due to chronic or repeated inflammation, scarring and blocking by mucous secretions. The contribution of emphysema and small airways disease to COPD varies between patients but the clinical significance of this is not yet known.
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