A 22-year-old woman presents with chronic productive cough producing large volumes of foul-smelling sputum and recurrent pneumonia since childhood. Vital signs: BP 118/76, HR 92, RR 20, Temp 37.2°C, SpO2 94% on room air. Examination reveals coarse crackles at bilateral lung bases; no wheezing noted. Chest X-ray shows bronchial wall thickening. High-resolution CT demonstrates permanently dilated bronchi with bronchus-to-artery ratio >1. Which pathophysiologic mechanism best explains this patient's bronchial abnormality?

1. A)Fibrosis confined to the visceral pleura
2. B)Repeated inflammation causing destruction of bronchial wall smooth muscle and elastic tissueGABARITO
3. C)Loss of alveolar septa from protease excess
4. D)Acute edema of the epiglottis from Haemophilus influenzae infection
5. E)Diffuse alveolar damage with hyaline membrane formation