COPD Pathogenesis

General Overview

• COPD pathogenesis involves both genetic susceptibility and environmental insults.
• Genetic susceptibility includes hereditary disorders such as alpha-1 anti-trypsin deficiency.
  • This disorder reduces the lung's ability to prevent damage to lung tissue.
• Environmental insults include:
  • Long-term smoking
  • Pollution
  • Infection

Mechanisms of Damage

• These factors generate free radicals in the lungs and inactivate lung anti-proteases.
• Combination of genetic and environmental factors leads to lung inflammation.
  • Results in oxidative stress, inflammatory cytokines, and increased protease function.

Effects of Chronic Inflammation

• Systemic Inflammation:
  • Affects both the bronchial tree (airways) and lung parenchyma (bulk of lung tissue).

Bronchial Tree (Airways)

• Mechanisms of Injury:
  • Infiltration of inflammatory cells, especially neutrophils, leads to airway fibrosis and narrowing.
  • Proliferation of goblet cells increases mucus production.
  • Death of ciliated cells causes debris formation, combining with mucus and leading to infection.
• Resulting Condition:
  • Chronic Bronchitis
  • Defined as part of COPD.

Lung Parenchyma

• Proteolytic Destruction:
  • Proteases destroy lung tissue proteins, reducing airway elasticity.
  • Reduces lung recoil ability, trapping air within the lungs.
  • Leads to loss of structural support, causing airway narrowing and collapse.
• Resulting Condition:
  • Emphysema
  • Characterized by permanent enlargement of alveoli, hyperinflation of lungs, and formation of bullae.

COPD Types

• Chronic Bronchitis and Emphysema are the most common conditions under COPD.

Further Information

• For more details, refer to related videos on clinical findings, physical examination, laboratory investigations, and complications of COPD.

Conclusion

• Understanding the pathogenesis of COPD is crucial for managing and treating the disease.
• Stay updated with new videos for more insights into COPD.