ABSTRACT
Pulmonary emphysema is a major component of the morbidity and mortality of chronic obstructive pulmonary disease (COPD), a condition that is estimated to afflict in excess of 24 million persons and has become the fourth leading cause of death in the United States. However, major increases in cigarette smoking are occurring in many underdeveloped countries, particularly China. Cigarette-related diseases will become the leading cause of death worldwide within a decade (1). COPD alone is expected to account for 1.5 million deaths per year in China within the next half century (2). Despite increasing knowledge regarding the mechanisms of COPD, there has been limited translation into pharmacotherapy for COPD. This chapter will explore the role of proteinases in the pathogenesis of emphysema. Strategies to inhibit lung destruction could halt the progression of airspace enlargement and airflow obstruction in COPD.
