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Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition. Patients display various pathophysiological and clinical features. These include chronic predominantly neutrophilic inflammation of the airways and irreversible airflow obstruction. This leads to emphysematous destruction of lung tissue and deterioration of pulmonary function. The most common cause is cigarette smoking. Genetics, childhood lung development and environmental exposures also play a role. The clinical presentation ranges from exertional dyspnea and respiratory tract infections, to progressive severe exacerbations of the disease. However, they may require hospitalisation, reduced exercise tolerance, respiratory failure, and associated co morbidity including pulmonary hypertension, sleep disordered breathing, depression and an increased risk of lung cancer. But it remains the third leading cause of death worldwide.1
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