Zusammenfassung der Ressource
COPD
- includes
- Emphysema
- Chronic Bronchitis
- small airway obstruction
- definition
- not fully reversible airflow limitation
- it must include
- chronic airflow obstruction
- PATHOGENESIS
- major physiologic change
- airflow limitation
- results from
- Emphysema
- due to
- lack of
TGF-B
- causes
- Emphysema
- Parenchymal inflam.
- comprises 4 events
- 1. Chronic exposure to cigarette smoke
- leads to
- infalmmatory & immune cell recruitment within the terminal spaces of the
lung
- 2. releases
- elastolytic & proteinases
- damage
- Lung ECM
- 3. structural (Endo, Epithelial) cell death
- occurs
- directly
- oxidant-induced cigarrete smoke
- senescence
- indirectly
- Matrix attatchment proteolytic loss
- 4. ineffective repair of
- elastin & other ECM components
- results in
- air space
enlargement
- small airway obstruction
- by
- hyperplasia & accumulation of cells
- mucuous
- fibrosis
- due to
- TGF-B
activation
- THE ELASTASE:ANTIELASTASE HYPOTHESIS
- A1-AT deff.
- ⬆️ risk of
- Emphysema
- immune & inflammatory cells
- additional proteinases
- INFLAMMATION & ECM PROTEOLYSIS
- AI mechanisms
- esp. in advanced cases
- ⬆️ B cells & lymphoid follicles
- IgG autoAb
- against
- pulmonary Epith.
- can potentially mediate
- cytotoxicity
- concomitant cigarette smoke-induced loss of cilia in the airway Epith. & impaired MQ phagocytosis
- CELL DEATH
- rt801 inhibition of mTOR
- leads to
- inflamm., proteolysis & cell death
- emphesyma therefore resembles
- premature aging of the lung
- INEFFECTIVE REPAIR
- Pathology
- Large airway
- Cigarette smoking
- results in
- mucous gland enlargement
- leading to
- Cough & sputum
- defines
- chronic bronchitis
- not related to airflow limitation
- ⬆️ in number (hyperplasia) & extent
- Small airways
- Lung parenchyma