A 59-year-old woman with a 25 pack-year smoking history is diagnosed with chronic obstructive pulmonary disease (COPD). What is the pathophysiology of the emphysema component of this disease process?

Inflammation of the bronchial wall leads to mucosal thickening, epithelial cell desquamation, and denudation of the basement membrane.

An irritant (usually smoking) causes an inflammatory response that leads to destruction of the alveolar air sacs, causing irreversible obstructive airway physiology.

Airway obstruction occurs due to the combination of inflammatory cell infiltration, mucus hypersecretion with mucus plug formation, and smooth muscle contraction.

The inflammatory response initiated by a bacterial infection causes leakage of the alveolar-capillary membrane at the site of inflammation, causing a decrease in lung compliance and shortness of breath.