14234311
Descripción
Mapa Mental por Roya Moalem, actualizado hace más de 1 año
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Creado por Roya Moalem
hace más de 7 años
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COPD
- includes
- Emphysema
- Chronic Bronchitis
- small airway obstruction
- Emphysema
- definition
- not fully reversible airflow limitation
- it must include
- chronic airflow obstruction
- chronic airflow obstruction
- it must include
- not fully reversible airflow limitation
- PATHOGENESIS
- major physiologic change
- airflow limitation
- results from
- Emphysema
- due to
- lack of
TGF-B
- causes
- Emphysema
- Parenchymal inflam.
- Emphysema
- causes
- lack of
TGF-B
- comprises 4 events
- 1. Chronic exposure to cigarette smoke
- leads to
- infalmmatory & immune cell recruitment within the terminal spaces of the
lung
- 2. releases
- elastolytic & proteinases
- damage
- Lung ECM
- Lung ECM
- damage
- elastolytic & proteinases
- 2. releases
- infalmmatory & immune cell recruitment within the terminal spaces of the
lung
- leads to
- 3. structural (Endo, Epithelial) cell death
- occurs
- directly
- oxidant-induced cigarrete smoke
- senescence
- oxidant-induced cigarrete smoke
- indirectly
- Matrix attatchment proteolytic loss
- Matrix attatchment proteolytic loss
- directly
- occurs
- 4. ineffective repair of
- elastin & other ECM components
- results in
- air space
enlargement
- air space
enlargement
- results in
- elastin & other ECM components
- 1. Chronic exposure to cigarette smoke
- due to
- small airway obstruction
- by
- hyperplasia & accumulation of cells
- mucuous
- fibrosis
- due to
- TGF-B
activation
- TGF-B
activation
- due to
- hyperplasia & accumulation of cells
- by
- Emphysema
- results from
- airflow limitation
- THE ELASTASE:ANTIELASTASE HYPOTHESIS
- A1-AT deff.
- ⬆️ risk of
- Emphysema
- Emphysema
- ⬆️ risk of
- immune & inflammatory cells
- additional proteinases
- A1-AT deff.
- INFLAMMATION & ECM PROTEOLYSIS
- AI mechanisms
- esp. in advanced cases
- ⬆️ B cells & lymphoid follicles
- ⬆️ B cells & lymphoid follicles
- IgG autoAb
- against
- pulmonary Epith.
- pulmonary Epith.
- can potentially mediate
- cytotoxicity
- cytotoxicity
- against
- esp. in advanced cases
- concomitant cigarette smoke-induced loss of cilia in the airway Epith. & impaired MQ phagocytosis
- AI mechanisms
- CELL DEATH
- rt801 inhibition of mTOR
- leads to
- inflamm., proteolysis & cell death
- emphesyma therefore resembles
- premature aging of the lung
- premature aging of the lung
- emphesyma therefore resembles
- inflamm., proteolysis & cell death
- leads to
- rt801 inhibition of mTOR
- INEFFECTIVE REPAIR
- major physiologic change
- Pathology
- Large airway
- Cigarette smoking
- results in
- mucous gland enlargement
- leading to
- Cough & sputum
- defines
- chronic bronchitis
- not related to airflow limitation
- not related to airflow limitation
- chronic bronchitis
- defines
- Cough & sputum
- leading to
- ⬆️ in number (hyperplasia) & extent
- mucous gland enlargement
- results in
- Cigarette smoking
- Small airways
- Lung parenchyma
- Large airway
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