Mrs. White's COPD Case Study

Mrs. White’s COPD is triggered mainly by her history of cigarette smoking. The noxious substances in cigarette smoke initiate the production of Tumor Necrosis Factor-a (TNF-a) and release of inflammatory mediators by macrophages and epithelial cells. In fact, the activated cells in COPD inflammation secrete a number of mediators. These include a variety of active proteinases, toxic peptides, and oxidants which damage lung structures and sustain inflammatory processes (_____). The resulting damage increases inflammation by secreting chemotactic peptides into the extra-cellular framework (___). The exaggerated inflammatory response further degrades elastin, a vital part of alveolar structures (__). In addition to inflammation, two mechanisms considered in COPD pathogenesis are the imbalance of anti-proteinases and proteinases, and “oxidative stress”. These factors may result from inflammation, or they may be consequences of environmental (e.g. cigarette smoke) or hereditary (e.g. alpha-1 anti –trypsin deficiency) components (______). …show more content…
The oxidants produced in cigarette smoke damage the parts of the lung structures, particularly elastin and collagen. These oxidants disrupt elastin production and repair which leads to the progression of emphysema. This is due to the direct contact of the alveolar epithelial surface to pollutants in the environment, e.g. cigarette smoke which increases the permeability of the epithelium. This imbalance triggers COPD symptoms as indicated by markers of oxidants in the breath, urine and fluid in the lining of the epithelium among COPD patients (__). Therefore, this repetitive “injury-and-repair process” leads to the remodelling of airway structures and increase in scar tissue production which narrow and block airway passages