Objective

Therapeutics for inflammatory diseases often target pathways present in excess. An alternative approach however would be to consider these diseases as an inability to stop repairing. What are the pathways that determine healthy lung architecture and how does the lung sense it has returned to the correct structure? In order to understand these processes, a detailed knowledge of what constitutes health, and the cross-talk between immune cells and underlying stroma is required. In this talk I will highlight important interactions in the healthy airspaces that are lost in inflammatory disease. I will also show how a constant turnover of apoptotic cells and extracellular matrix causes a number of the characteristic pathological features of Chronic Obstructive Pulmonary Disease (COPD). A view point through the other end of the telescope will lead to a raft of new concepts amenable to therapeutic development.