COPD pathophysiology

Pathophysiology

  • airflow obstruction that's not reversible
  • inflammatory condition
    • cigarette smoke/irritants activate macrophage/epithelial cells
    • neutrophil chemotactic factors released
    • proteases destroys lung parenchyma
    • protease inhibitors (a1-antitrypsin) reduced in COPD
    • oxidative stress: inflammation, tissue destruction
    • ultimately: fibrosis of small airway, reduced elastic recoil, static hyperinflation
    • ability to exhale decreases
    • inhalation initiated before exhalation => hyperinflation, air trapping

Risk Factors

  • smoke exposure
  • air pollution: cooking with biomass fuel indoor
  • occupational chemical/dust
  • a1-antitrypsin deficiency