Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Asthma is characterized in part by reversible airflow obstruction, hyperresponsiveness, and inflammation. Chronic obstructive pulmonary disease, which includes chronic bronchitis, emphysema, and possibly bronchiectasis, is defined as predominantly irreversible airflow obstruction associated with abnormal airway inflammation. Traditional concepts concerning airway inflammation have focused on trafficking leukocytes and on the effects of inflammatory mediators, cytokines, and chemokines secreted by these cells. Airway smooth muscle, the major effector cell responsible for bronchomotor tone, has been viewed as a target tissue responding to neurohumoral control and inflammatory mediators. New evidence, however, suggests that airway smooth muscle may secrete cytokines and chemokines and express cellular adhesion molecules that are important in modulating submucosal airway inflammation. Other new evidence suggests that beta-adrenergic agents may inhibit some but not all of the inflammatory responses. In certain circumstances, increasing levels of cyclic adenosine monophosphate in the cytosol of airway smooth muscle promote the secretion of other cytokines or chemokines. The cellular and molecular mechanisms that regulate the immunomodulatory functions of airway smooth muscle may offer new and important therapeutic targets in treating these common lung diseases.
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PMID:Airway smooth muscle: an immunomodulatory cell. 1246 35

Asthma and COPD are the most prevalent of lung diseases and contribute an enormous burden of morbidity in North America and globally. In both conditions, inflammation leads to airway remodeling, which contributes to airway narrowing. To date, airway remodeling has only been assessed using histological examination of airways. However, it may now be possible to assess and quantify the extent of airway remodeling in vivo using high-resolution CT (HRCT). The aim of this article is to review the use of HRCT in the investigation of airway remodeling. A number of investigators have reported techniques to make measurements of airway dimensions using CT and an increasing number of quantitative methods are being developed. Using these techniques, airway dimensions have been examined in patients with asthma and COPD. In patients with asthma, the airway wall area was increased without a decrease in luminal area, whereas in patients with COPD, the airway luminal area was decreased and airway wall area was increased. The different pattern of remodeling may reflect fundamental differences in the inflammatory processes in asthma and COPD and could influence the reversibility of the narrowing. It has also been shown that, by quantifying both the extent of emphysema and of airway remodeling, CT is useful in differentiating COPD patients who have primarily parenchymal disease from those who have primarily airway pathology. With additional advances in technology, it is likely that quantitative assessment of airway wall dimensions will ultimately provide a valuable tool for the study of airway disease.
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PMID:Quantitative assessment of airway remodeling using high-resolution CT. 1247 96

Asthma and chronic bronchitis are characterized by bronchial occlusion in expiration. Acute spasmodic asthma, if prolonged, may bring about changes in thoracic structure and diaphragm position which can result in permanent pulmonary inefficiency unless this tendency is corrected by breathing exercises. As expiratory obstruction becomes more chronic, irreversible emphysema develops. Thereafter therapy for bronchopulmonary insufficiency is necessary. The approaches to such therapy have been outlined and briefly evaluated, with emphasis upon the value of intermittent positive-pressure therapy.
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PMID:Emphysema in chronic bronchitis and asthma; a practical therapeutic approach. 1328 40

Matrix metalloproteinases (MMPs) are an at least 23 member family of calcium and zinc dependent enzymes implicated in many physiological and pathological processes. Asthma, chronic obstructive pulmonary disease (COPD) and emphysema are diseases associated with an inflammation of the airways and lung parenchyma. In this review, we focus on the role played by MMPs in the pathogenesis of inflammation, airway remodelling and alveolar destruction, depicting the observational studies in humans and the experimental studies in animal models. During the course of asthma, MMP-2,-8,-9 and TIMP-1 are expressed at baseline and the allergen exposure or exacerbations of the disease lead to an increase of MMP-9 secretion being at this time much higher than that of TIMP-1, allowing temporarily a matrix damage, possibly followed by abnormal repair. Animal models suggest a predominant role for MMP-9 and MMP-12 in the pathogenesis of pulmonary inflammation and link an absence of MMP-2 to an increased parenchymal inflammation. In COPD and emphysema, human studies indicate an over-secretion of MMP-2,-8,-9 and animal models pointout MMP-1 and MMP-12 as being key players in the pathogenesis of emphysema. Taken together, these data identify specific MMP inhibition as appropriate target for therapeutic intervention in asthma or COPD/emphysema They also strongly argue against the widespread use of large spectrum non specific inhibitors that could be detrimental.
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PMID:Pathogenic role of matrix metalloproteases and their inhibitors in asthma and chronic obstructive pulmonary disease and therapeutic relevance of matrix metalloproteases inhibitors. 1465 45

Although many medical problems are generally managed in concert with a general medical physician, it is important for the podiatric physician to be familiar with some of the major diseases of the lung. Pneumonia, an infectious process within the lung, is the sixth-leading overall cause of death. Antibiotic treatment, oxygen administration, and supportive care are the mainstays of its therapy. Chronic obstructive pulmonary disease presents as a spectrum from chronic bronchitis, with a greater inflammatory component, to emphysema, with a more significant destructive component. Asthma, often a more episodic chronic obstructive disease, is characterized by inflammation of the airways leading to their narrowing. The work of breathing is often increased in these diseases, and treatment is with combination therapies with a focus on smoking cessation. Thromboembolic disease, the occlusion of blood vessels with consequent interruption of blood flow, may occur in a patient with risk factors, especially after surgery. Treatment is with anticoagulation agents or in some cases with thrombolysis. Prophylaxis is key.
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PMID:Pulmonary disease: pneumonia, chronic obstructive pulmonary disease, asthma, and thromboembolic disease. 1502 93

Recent studies suggest that thoracal high resolution computed tomography (HRCT) of the thorax can detect the irreversible structural changes in chronic asthma cases. This study is aimed to evaluate these possible changes and their relation with asthma severity. Twenty-eight stable asthmatic patients with normal conventional radiography and 10 healthy controls were included. Twenty of the patients were female (71.4%) and the mean age of the group was 43 +/- 10.5 (30-61). The groups were divided into 2; as group 1 included mild intermittent and mild persistent cases, and group 2 included moderate and severe persistent cases. Asthma and control group, and group 1 and 2 were compared according to the thickness of airwall (T), thickness to outer diameter (T/D), wall area (WA), the percentage wall area (WA%). HRCT showed that air trapping, bronchiectasis, fibrotic lesions and airwall thickening were significantly more common in asthma group (p< 0.05). Emphysema, acinar pattern, collapse and mucoid impact were common in asthma group (p> 0.05). The incidence of T and WA was higher in asthma group but also did not reach statistical significance and the thickening of airwall in small airways was significantly more in asthma group. Any correlation between HRCT findings and asthma severity was not found. So reversible and irreversible bronchial and parenchymal changes, detected by HRCT but not by plain chest radiograms, may be present in asthma cases. The early detection of these changes may lead more aggressive asthma management.
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PMID:[High resolution computed tomography findings in patients with asthma]. 1510 Aug 97

The prevalence of obstructive airways disease in the disadvantaged elderly population is underestimated. Consequently, asthma may be suboptimally managed in this population leading to poorer symptom control and quality of life in this group. The objective of this study was to estimate the prevalence of obstructive airways disease (OAD) in a disadvantaged elderly population. A cross-sectional study was conducted in which we interviewed older adults at centers subsidized by the Chicago Department on Aging. Participants were individuals who agreed to complete a five-page questionnaire about their health. Three hundred eighty individuals agreed to fill out a questionnaire about their health. The mean and median age was 74 years. There were 38 (10%) individuals with self-report of doctor-diagnosed asthma, 40 (11%) individuals with doctor-diagnosed chronic bronchitis, and 14 (4%) individuals with doctor-diagnosed emphysema. They had these diagnoses for a mean of 10.4 years (range, 0-50 years). Thirty-three (9%) individuals who did not have doctor-diagnosed disease had wheezing or whistling when they breathed and shortness of breath or cough with exercise. Of those 125 individuals with doctor-diagnosed disease or symptoms suggestive of OAD, only 22 (18%) individuals took their prescribed medications on a regular basis. Symptoms of OAD appear to be common in the disadvantaged elderly in Chicago. Based on these results, 92 (24%) individuals had doctor-diagnosed asthma, chronic bronchitis, and/or emphysema. The majority did not take their medications regularly. Another 33 (9%) individuals had symptoms compatible with OAD that had not been diagnosed or treated.
Allergy Asthma Proc
PMID:Prevalence of obstructive airways disease in the disadvantaged elderly of Chicago. 1531 21

Chronic obstructive pulmonary disease (COPD) is often misdiagnosed as asthma, leading to inappropriate treatment and suboptimal patient outcomes. As part of a prospective study of patients with a history consistent with obstructive lung disease, we compared prior diagnostic labels with a study diagnosis based on spirometric results. We enrolled persons 40 years of age or older with prior diagnoses or medications consistent with obstructive lung disease. Patients were recruited via random mailing to primary care practices in Aberdeen, Scotland, and Denver, Colorado. Prior diagnoses of chronic bronchitis or emphysema (CBE) and asthma were reported by the subjects. Participants underwent pre- and post-bronchodilator spirometry. A study diagnosis of COPD was defined using post-bronchodilator forced expiratory volume in 1 second/forced vital capacity (FEV(1)/FVC) < 0.70. Spirometric examination was complete in 597 patients, of whom 235 (39.4%) had a study diagnosis of COPD. Among subjects with a spirometry-based study diagnosis of COPD, 121 (51.5%) reported a prior diagnosis of asthma without concurrent CBE diagnosis, 89 (37.9%) reported a prior diagnosis of CBE, and 25 (10.6%) reported no prior diagnosis of obstructive lung disease. Despite the availability of consensus guideline diagnostic recommendations, diagnostic confusion between COPD and asthma appears common. Increased awareness of the differences between the two conditions is needed to promote optimal patient management and treatment.
J Asthma
PMID:Misdiagnosis of COPD and asthma in primary care patients 40 years of age and over. 1644 70

Analysis of ambient air quality data monitored at Colombo Fort monitoring unit clearly revealed that PM(10) is the dominant air pollutant in the Colombo atmosphere. Further investigation showed that PM(10) has strong associations with three types of respiratory illnesses, especially among children. Among these associations, the disease category which includes bronchitis, emphysema and other chronic obstructive pulmonary diseases showed a prominent association with a correlation coefficient of 0.717 at 99% confidence. In addition, an application of health impact assessment software developed by WHO revealed that nearly 20% of Asthma patients recorded at LRH (the Lady Ridgeway Hospital for Children) in 2005 could be attributed to exposure to PM(10) in Colombo. It was observed that nearly 60% of the respiratory cases occurred at reasonably lower concentrations (below 80 microgm(-3)) thus, future management plans aiming toward positive health impacts should focus on shifting the entire PM(10) pollution distribution towards lower ends.
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PMID:Ambient PM(10) and respiratory illnesses in Colombo City, Sri Lanka. 1856 21

Airway remodeling can be assessed using high-resolution computerized tomography (HRCT) scanning of both parenchymal-and airway abnormalities in patients with asthma. The aim of this study was to examine structural changes in large and small airways of asthmatic patients using HRCT to determine if remodeling changes had occurred after prolonged use of conventional anti-asthma therapy. HRCT scans were evaluated prospectively for evidence of the following abnormalities: bronchial wall thickening (BWT), bronchiectasis, mucoid impactions, small centrilobular opacities, thick linear opacities, focal hyperlucency, and emphysema. Fifty mild and moderate asthmatics were enrolled in the study group. These abnormalities were re-evaluated in the patients after the passage of 6 years of regular anti-asthma medication. Forty-six of the patients completed the study. The probability of finding at least one abnormality by HRCT investigation was statistically higher in the second scan than in the first (26 patients [56.5%] versus 18 patients [39.1%], p = 0.02]. Irreversibility ratios of abnormalities were 80%, 100%, 75%, 87.7%, 77.8%, and 100% for BWT, bronchiectasis, small centrilobular opacities, focal hyperlucency, thick linear opacity, and emphysema, respectively. The ratios for newly detected structural abnormalities were 25%, 2.5%, 0%, 7.9%, 8.1%, and 0% for BWT, bronchiectasis, small centrilobular opacities, focal hyperlucency, thick linear opacity, and emphysema, respectively. New occurrences and progression in BWT are associated with the duration of asthma affliction (p = 0.03). The results of our study indicate that HRCT remodeling features, once occurring, are irreversible in most of the patients, and new remodeling features also occur despite administering the standard asthma treatment.
J Asthma 2009 Apr
PMID:Irreversiblity of remodeled features on high-resolution computerized tomography scans of asthmatic patients on conventional therapy: a 6-year longitudinal study. 1937 40


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