COPD

Question 1

What is COPD?

Answer 1

Chronic Obstructive Pulmonary Disease
- Sites —> lungs
—> small airways
- Inflammatory cells —> neutrophils
—> macrophages
—> Tc1 lymphocytes
- Mediators —> TNFα, IL-8, LTB4
- normally no co-morbidities

Question 2

What is asthma?

Answer 2

Chronic Obstructive Pulmonary Disease
- Sites —> lungs
—> large airways
- Inflammatory cells —> eosinophils
—> mast cells
—> Th2 lymphcytes
- Mediators —> IL-4, IL-5, cysLTs
- Treatments —> bronchiodilators
—> corticosteroids

Question 3

What are the 2 main physiological consequences of asthma?

Answer 3

1. Bronchoconstriction —> wheezy
2. Excessive mucus —> mucus plugs block airways

Question 4

What are the 3 main physiological consequences of COPD?

Answer 4

1. Chronic bronchitis —> mucus hypersecretion
   - mucus plugs
2. Chronic bronchiolitis —> small airway disease
   - fibrosis
3. Emphysema —> alveolar attachment destruction
   - fibrosis

Question 5

What is the pathophysiology of COPD?

Answer 5

Smoking —> activates macrophages
- activates neutrophils
- activates Tc cells
—> damage epithelial cells
- activates Tc cells
- activates fibroblasts via TGFβ
—> oxidants
- activates proteases - neutrophil elastase
- MMPs
—> mucus hypersecretion
(bronchitis)
—> emphysema
—> SAD

Question 6

What are the current pharmaceutical treatment options for COPD?

Answer 6

Bronchiodilators and antiinflammatory glucocorticoids —> ineffective
- future —> need protease inhibitors