Fig. 1

A mechanism showing the central role of oxidative stress in the pathophisiology of COPD. The imbalance between oxidants and antioxidants in favor of oxidants leads to harmful damage. Oxidative stress amplifies the inflammatory response influencing intracellular signaling pathways that drive the release of inflammatory mediators, impairing fagocytosis of apoptotic cells and weakening the ability of corticosteroids to repress proinflammatory genes expression. Inflammation, lipid peroxidation, protein oxidation and DNA damage results in tissue damage, alteration of protein functions and gene expression, remodeling of extracellular matrix and mucus secretion