RESPIRATORY
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
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Question
[CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
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Smoking substances stimulate macrophages to further secrete a variety of cytokines
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Cytokines activate neutrophils and secrete proteases to destroy alveolar structures
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Cytokines also activate helper T cells (CD4 T cells, helper T cells), causing damage to the alveolar structure
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Smoking substances also stimulate fibroblasts, leading to fibrosis of the airways
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Detailed explanation-1: -CCL2 is a potent chemoattractant of monocytes and may therefore be involved in the accumulation of macrophages in the lungs of patients with COPD. CCR5 is activated by CCL3 (MIP-1), CCL4 (MIP-1), and CCL5 (regulated on activation, normal T-cell expressed and secreted), all of which are elevated in COPD.
Detailed explanation-2: -Chronic obstructive pulmonary disease (COPD) is characterised by poorly reversible airflow obstruction and an abnormal inflammatory response in the lungs. The latter represents the innate and adaptive immune responses to long term exposure to noxious particles and gases, particularly cigarette smoke.
Detailed explanation-3: -Most patients with COPD have all three pathological mechanisms (chronic obstructive bronchiolitis, emphysema and mucus plugging) as all are induced by smoking, but may differ in the proportion of emphysema and obstructive bronchiolitis 2.
Detailed explanation-4: -Reactive oxygen species. The excessive production of reactive oxygen species damages the lung tissue and results in oxidative stress, which is a primary pathogenic process in COPD. The phagocytes (neutrophils and macrophages) and epithelial cells all produce ROS and this process is enhanced in patients with COPD.