Understanding the mechanisms of immune-evasion by lung cancer in the context of chronic inflammation in emphysema

Ramin Salehi-Rad, Steven M. Dubinett


Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder that constitutes the third leading cause of death worldwide. The presence of COPD is associated with an increased incidence of lung cancer, even after correction for the risk associated with cumulative tobacco exposure (1). Furthermore, the severity of COPD, as defined by the degree of airflow obstruction or the severity of radiographic emphysema, portends a worse prognosis in patients with lung cancer (2). Although our understanding of the pathophysiology of COPD and lung cancer is rapidly evolving, the underlying mechanisms of the epidemiologic link between COPD and lung cancer remain obscure (3). Accumulating evidence suggests that smoke-induced chronic airway inflammation could serve as a potential link between these two disease processes.