Pathophysiology of Emphysema
DOI:
https://doi.org/10.36497/jri.v39i1.43Keywords:
emphysema, obstruction, elastic recoil reduction, hyperinflation, equal pressure point, early airway closureAbstract
Pulmonary emphysema is part of pathological condition in chronic obstructive pulmonary disease (COPD) which is characterized by lung parenchymal destruction. Morphology classification of emphysema had been made according to histologic structure in pathology. There were some causes known to be the culprit of emphysema; one that caught most attention is protease-antiprotease activity from cigarette smoke exposure. Destructive effect of emphysema gives disturbance of lung function in expiration (obstruction). The primary mechanism is elastic recoil reduction which causes air trapping, lung volume increase, lung compliance increase and airways that is susceptible to collapse. Hyperinflation in emphysema causes some disadvantages which complicate inspiration and give a dyspnea sensation. Equal pressure point drop in emphysema happens because of elastic recoil reduction. This drop may cause early airway closure. (J Respir Indo 2019; 39(1): 60-9)Downloads
References
Macnee W, Vestbo J, Agusti A. COPD: pathogenesis and natural history. In: Broaddus VC, Mason RJ, et al, editors. Murray & Nadel’s textbook of respiratory medicine . 6th ed. . Vol.1. Philadelphia: Elsevier Saunders; 2016. p. 75161.
Kemp SV, Polkey MI, Shah PL. The epidemiology, etiology, clinical features, and natural history of emphysema. Thorac Surg Clin. 2009;19:149–58.
Wright JL, Churg A. Pathologic features of chronic obstructive pulmonary disease: diagnostic criteria and differential diagnosis. In: Fishman AP, Elias JA, et al, editors. Fishman’s pulmonary diseases and disorders. 4th ed. New York: McGrawHill; 2008. p.6939.
Petty TL. The history of COPD. Int J Chron Obstruct Pulmon Dis. 2016;1(1):314.
Foronjy R, D’Armiento J. The role of collagenase of emphysema. Respir Res. 2001;2:34852.
Antunes MA, Rocco PRM. Elastaseinduced pulmonary emphysema: insights from experimental models. Anais da Academia Brasileira de Ciências. 2011;83(4):138595.
Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187(4):34765.
Sharafkaneh A, Hanania NA, Kim V. Pathogenesis of emphysema: from bench to bedside. Proc Am Thorac Soc. 2008;5:475–7.
Gough J. The pathology of emphysema. Postgrad Med J.1995;41:392400.
Bagdonas E. Raudoniute J, Bruzauskaite I, Aldonyte R. Novel aspects of pathogenesis and regeneration mechanisms in COPD. Int J Chron Obstruct Pulmon Dis. 2015;10:995–1013.
Morris DG, Sheppard D. Pulmonary emphysema: when more is less. Physiology. 2006;21:396403.
Weinberger SE, Cockrill BA, Mandel J. Chronic obstructive pulmonary disease. In: Weinberger SE, Cockrill BA, Mandel J, editors. Principles of pulmonary medicine. 6th ed. Philadelphia: Elsevier Saunders; 2014. p.91109.
Martin C, Frija J, Burgel PR. Dysfunctional lung anatomy and small airways degeneration in COPD. International Journal of COPD. 2013;8:7–13.
West JB. Obstructive diseases. Pulmonary pathophysiology: the essentials. 8th ed. Baltimore: Williams and Wilkins; 2013. p. 4862.
Paré PD, Mitzner W. Airwayparenchymal interdependence. Compr Physiol. 2012;2(3):1921–35.
O’Donnell DE, Laveneziana P. Physiology and consequences of lung hyperinflation in COPD.
Eur Respir Rev. 2006;15(100):617.
Senior RM, Atkinson JJ. Chronic obstructive pul monary disease: epidemiology, patho phy siology, and pathogenesis. In: Fishman AP, Elias JA, et al, editors. Fishman’s pulmonary diseases and disor ders. 4th ed. New York: McGrawHill; 2008. p. 7114.
Rossi A, Aisanov ZR, Avdeev S, Maria GD, Donner CF, Izquierdo JL, et al. Mechanisms, assessment and therapeutic implications of lung hyperinflation in COPD. Respir Med. 2015;109(7):785802.
Braun CA, Anderson CM. Pathophysiology: functional alterations in human health. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 32930.
McCance KL, Huether SE, Brashers VL, Rote NS. Pathophysiology: the biologic basis for disease in adults and children. 7th ed. Missouri: Elsevier Mosby; 2014. p. 12689.
Voets PJGM, van Helvoort HAC. The role of equal pressure points in understanding pulmonary diseases. Adv Physiol Educ. 2013;37:266–7.
Mulroney S, Myers A. Netter’s essential physiology. Philadelphia: Elsevier Saunders; 2009. p. 1714.
Levitzky MG. Mechanics of breathing. Pulmonary physiology. 7th ed. New York: McGrawHill; 2007. p. 3740.
Milne S, King GG. Advanced imaging in COPD: insights into pulmonary pathophysiology. J Thorac Dis. 2014;6(11):1570-85.
Goldin JG. Imaging the lungs in patients with pulmonary emphysema. J Thorac Imaging. 2009;24(3):163-70.
Takahashi M, Fukuoka J, Nitta N, Takazakura R, Nagatani Y, Murakami Y, et al. Imaging of pulmonary emphysema: a pictorial review. Int J Chron Obstruct Pulmon Dis. 2008;3(2):193-204.
Downloads
Additional Files
Published
Issue
Section
License
- The authors own the copyright of published articles. Nevertheless, Jurnal Respirologi Indonesia has the first-to-publish license for the publication material.
- Jurnal Respirologi Indonesia has the right to archive, change the format and republish published articles by presenting the authors’ names.
- Articles are published electronically for open access and online for educational, research, and archiving purposes. Jurnal Respirologi Indonesia is not responsible for any copyright issues that might emerge from using any article except for the previous three purposes.