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xangxelax
on FreezingBlue Flashcards.
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Answer the question, “what is COPD?”
- Progressive decline in respiratory function
- Chronic progressive airflow limitation - not necessarily an obstruction
- No bronchospasm
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Provide an overview of the pathogenesis of COPD
- Environmental insults
- Inappropriate inflammation and excessive mucus secretion
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Explain the role of inflammation in the systemic manifestations of COPD
- Significant sources of neutrophil elastase, proteases, and free radicals
- Cigarette smoke decreases deformability of neutrophils trapping them w/in small capillaries
- Number of macrophages is elevated throughout the lung - they secrete proinflammatory cytokines, leukotrienes, free radicals, and proteases
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Discuss the protease-antiprotease imbalance hypothesis for the pathogenesis of COPD and cite evidence in support of it
Given the excessive activation of immune cells in response to inflammation - the MMP/ TIMP ratio increases and proteases become unopposed
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Describe the most common genetic risk factor contributing to the pathogenesis of COPD
- a1-antitrypsin deficiency - inhibits proteases made by the liver and released into the bloodstream
- Inhibits trypsin, elastase, collagenase, and is required to protect the lung from proteolytic degradation following activation of cells of the immune system
- Reduced expression of a1-antitrypsin or increased expression of neutrophil elastase leads to early onset emphysema - accounts for 1-2% of all cases of COPD
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What are some of the characteristics of chronic bronchitis?
- Mucous gland hyperplasia
- Inflammatory infiltrate
- Edema
- Fibrosis
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What is pink puffer?
Emphysema causing enlargement of airspaces distal to terminal bronchioles due to destruction of alveolar septa which leads to loss of elasticity, hyperinflation, and air trapping
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What are the 2 significant proteases that contribute to loss of alveoli?
- Neutrophil elastase
- Matrix metalloprotease 12
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