Pathological events | Loss of the terminal and transitional bronchioles | Emphysematous destruction | Loss of lung function |
Narrowing of airway lumens and thickening of airway walls | |
Epigenetic reprogramming, remodelling and hyperplasia of airway basal cells | Abnormalities in airway epithelial junction formation of the small airway epithelium | |
Immunological events | | Infiltration of B-cells | Formation of lymphoid follicles |
Innate lymphoid cells inducing Th1 responses | |
Blunted immune tolerance |
Infiltration of alveolar macrophages, dendritic cells, CD4 and CD8 T-cells |
Progressive decrease in lung microbial diversity |
Innate immune deficit in bacterial opsonisation and phagocytosis |