Pathophysiology and classification of emphysema

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), chronic obstructive pulmonary disease (COPD) is currently defined as a disease state characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases . According to this concept, the chronic airflow obstruction characteristic of this condition is a mixture of small airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), and the relative contributions of each of these factors vary from patient to patient according to his/her individual response. This chronic inflammation causes remodeling and obstruction of small airways and destruction of lung parenchyma, which produces loss of alveolar attachments to the small airways, resulting in decreased lung elastic recoil, diminishing the airway's capacity to remain patent during exhalation. These changes can be measured accurately by spirometry, providing a standardized, objective, and reproducible way to measure airflow limitation .
Source: Chest Surgery Clinics of North America - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research