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Pathogenesis of Emphysema

1983; Elsevier BV; Volume: 83; Issue: 4 Linguagem: Inglês

10.1378/chest.83.4.679

1931-3543

John R. Hoidal, Dennis E. Niewoehner,

Occupational and environmental lung diseases

Emphysema has been recognized as a pathologic entity and as a cause of dyspnea for nearly two centuries. 1 Laennec RJH Treatise on diseases of the chest and on mediate ausculation. 4. Longman Rees & Co, Forbes J, Transl. London1834: 141-162 Google Scholar It is an important medical problem which, with chronic bronchitis, ranks second only to coronary artery disease as a cause of disability compensation under the Social Security Administration. The total annual cost has been estimated to be greater than $1.5 billion. The mortality associated with emphysema is equally impressive, resulting in greater than 20,000 deaths in the United States each year. The major causative factor identified is cigarette smoking. 2 US Public Health Service. Smoking and health: a report of the Surgeon General. DHEW publication no. (PHS) 79-50066. US Government Printing Office, 1979 Google Scholar Since campaigns to encourage individuals to quit smoking have had limited success, better understanding of the mechanisms underlying emphysema is needed so that methods of interrupting the lung injury can be tested and proved useful. This review concentrates on possible mechanisms of the pathogenesis of emphysema, particularly as they may relate to cigarette smoke-induced disease.