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Inflammation COPD is characterised by the presence of CD+8 T-cells and macrophages in bronchial biopsies and an abundance of neutrophils in sputum. these tissue findings are contrast to asthma,where eosinophils are the dominant cell types.
interestingly,during exacerbations of mild COPD,a change in airway inflammation has been reported with increase in sputum eosinophuls. the rise in sputum eosinophils has been attributed to an increase in the expression. the benefits of steroid therapy during COPD exacerbation  can be explained by its impact on RANTES,a steroid sensitive eosinophils cytokine.
the sevarity of inflammation in COPD has been found to correlate with disease severity.As corroborated by saetta and colleagues,there is and inverse  relationship between the numbers of CD8+ lymphocytes present in the small airways and lung function in COPD patients.In addition,rapid  decline of forced experatory volume in 1 second ( FEV ) has been associated with increased levels of sputum neutrophils.

Moreover,the intensity of inflammation in individuals has also been found to correspond to the severity of GOLD stage ( Figure 1 ), with noticeable inflammation being present even in the early stages of COPD.

Evidence indicates that inflammations may play a role in the systemic manifestation of COPD. A study by agusty and colleagues has demonstrated increased skeletal muscle apoptosis in patients with COPD as compared to healthy controls. Additionally,COPD has been associated with an increase in age related arterials stiffnes as measured by aortic pulse wave velocity (aPWW), an independent prognosticfactor for cardiovascular risk.The severity of COPD as compared to normal individuals,matched for age  amd s,oking history with and inverse relationship demonstrated between aPWW and FEv.

Conversely.systemic diseases also have an impact in augmenting airway pathology,in study conducted in japan it was seen that the rate of decline of FEV, was faster in smoking COPD patients who where hepatitis C positive as compared to smoking COPD hepatitis C negative patients.

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