Pathophysiology of COPD
COPD refers to a group of lung diseases characterized by chronic obstruction of lung airflow that interferes with normal breathing (Global Initiative for Chronic Obstructive Lung Disease, 2019). The most common conditions included are chronic bronchitis and emphysema.
Cigarette smoking is the primary risk factor, with other factors like air pollution and genetics playing a smaller role. In chronic bronchitis, long-term inflammation of the airways causes mucus overproduction and damage to cilia – the tiny hairs that move mucus out of the lungs. This leads to a persistent cough with mucus (Global Initiative for Chronic Obstructive Lung Disease, 2019).
In emphysema, destruction of the alveoli (air sacs of the lungs) occurs. Normally elastic alveoli are weakened, resulting in overinflation on inhalation that cannot be reversed on exhalation. This loss of elastic recoil makes it difficult to exhale fully.
In COPD, chronic inflammation from noxious particles and gases causes a protease-antiprotease imbalance, destroying the lung parenchyma over decades (Global Initiative for Chronic Obstructive Lung Disease, 2019). Other mechanisms involve oxidative stress and apoptosis of lung cells.
Symptoms include breathlessness, chronic cough, and mucus production. Lung function progressively declines, impairing gas exchange and physical activity. Treatment focuses on smoking cessation, vaccinations, bronchodilators, anti-inflammatories, pulmonary rehabilitation, and in severe cases, oxygen therapy or lung transplantation.
Understanding the pathophysiological changes in COPD helps guide management strategies for this prevalent respiratory disease. Please let me know if you need any clarification or have additional questions.
References
Global Initiative for Chronic Obstructive Lung Disease. (2019). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease.
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