Background: Chronic obstructive pulmonary disease (COPD) occurs due to chronic inflammation, which leads to thickening of the airway walls, increased mucus production and, ultimately, permanent changes in lung structure. Meta-analysis indicates an increased risk of lung cancer in patients with COPD, so timely and comprehensive cancer prevention is extremely important. Objective: Determine the mechanisms of interaction between immune peptides and immunocompetent cells, which lead to the elimination of pathogens and prevent the development of metaplasia on the background of chronic inflammation. Methods: Selection and analysis of open access scientific publications. Results: Restoring the ability of secretory cells to synthesize IgA and maintaining this synthesis at the appropriate level can provide the necessary protection of the respiratory system from infection. Strengthening immune surveillance over the mucous membrane promotes not only the elimination of pathogens, but also to the destruction and removal of disabled and infected cells and cells that have undergone metaplasia -this is how the immunity program is implemented to counteract infection and prevent cancer. Conclusion: The use of exogenous anti-infective peptides for the treatment and prevention of exacerbations of COPD in the context of antibiotic resistance, to stimulate airway immune function and to prevent cancer is currently considered a promising area in clinical pulmonology.