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COPD

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Mind Map on COPD, created by Roya Moalem on 22/06/2018.
Roya Moalem
Mind Map by Roya Moalem, updated more than 1 year ago
Roya Moalem
Created by Roya Moalem over 6 years ago
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Resource summary

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

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