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8 Cards in this Set
- Front
- Back
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Two defining features of COPD?
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Chronic bronchitis
Emphysema |
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Prevalence
Risk factor |
Common
17% in men between 40-64 years Smoking main risk factor Hereditary alpha1 antitrypsin deficiency |
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Role of alpha1-antitrypsin
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Inhibition of neutrophil elastase; proteolytic enzyme capable of destroying the connective tissue supporting alveoli
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Describe pathophysiology of Emphysema
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Protease/antiprotease hypothesis
Airways of smokers are infiltrated by neutrophil granulocytes. Because smoke activates macrophages, CD8 T cells and Th1 Cells Degranulation of these inflammatory cells releases elastase and other proteases which then contribute to tissue destruction Stratified columnar epithelium becomes stratified squamous and loses their cilia |
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Chronic bronchitis features
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hypertrophy of mucous secreting glands in the bronchial tree.
XS mucous production and expectoration of sputum |
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Cytokines released?
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TNF - A, IFN G, MMPs & IL-1,6,8
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Problem with trapped air?
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There is a build-up of trapped air as the alveoli collapse on exhalation, impeding airflow and reducing lung capacity.
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Often infective exacerbations by
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Haemphilus influenzae or Strep. pneumoniae
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