RESUMEN

La enfermedad pulmonar obstructiva crónica es una enfermedad crónica compleja que involucra diversos tipos de células y mediadores inflamatorios. Las relaciones entre estos tipos de células, citocinas y la secuencia de eventos que culmina con limitación progresiva del flujo de aire y destrucción del parénquima pulmonar, no es del todo clara. Se reconoce como una enfermedad sistémica con importantes manifestaciones extrapulmonares que tienen repercusiones en diferentes órganos. Diversos problemas de salud se inician por fumar tabaco, empezando por el daño directo del tejido pulmonar por gases nocivos contenidos en el humo de cigarro y, posteriormente, por la activación directa de macrófagos, neutrófilos y células residentes del tejido por partículas del humo y/o por la inducción de procesos de reparación. Existen dos hipótesis que tratan de explicar esta respuesta anormal: 1) un desequilibrio en el sistema oxidantes/antioxidantes y 2) un desequilibrio en el sistema proteasas/antiproteasas. Con respecto a los mecanismos celulares involucrados en el proceso inflamatorio local, se ha descrito el papel que juegan los linfocitos T CD8+ activados por señales de alarma producidas por células presentadoras de antígeno, que a su vez han sido activadas por exposición a patógenos, toxinas, daño mecánico y humo de cigarro.

PALABRAS CLAVE

EPOC, inflamación pulmonar, citocinas, mediadores inflamatorios, proteínas de fase aguda.

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