Bronchiectasis pathophysiology: Difference between revisions
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{{CMG}} {{AE}} Saarah T. Alkhairy, M.D. | {{CMG}} {{AE}} Saarah T. Alkhairy, M.D. | ||
= Overview== | |||
Bronchiectasis involves bronchi that are permanently [[dilated]] inflamed, and easily collapsible. This results in airflow obstruction and impaired clearance of [[secretions]] Cole's Cycle describes how infections and a defect in the host defense are factors for this disease. An immune response also plays a role in the pathogenesis | Bronchiectasis involves bronchi that are permanently [[dilated]] inflamed, and easily collapsible. This results in airflow obstruction and impaired clearance of [[secretions]] Cole's Cycle describes how infections and a defect in the host defense are factors for this disease. An immune response also plays a role in the pathogenesis. | ||
==Pathophysiology<ref>{{cite journal |author=Morrissey BM |title=Pathogenesis of bronchiectasis |language=English |journal=Clin Chest Med|volume=28 |issue=2 |pages=289-96 |year=2007 |pmid=17467548 |doi=}}</ref>== | ==Pathophysiology<ref>{{cite journal |author=Morrissey BM |title=Pathogenesis of bronchiectasis |language=English |journal=Clin Chest Med|volume=28 |issue=2 |pages=289-96 |year=2007 |pmid=17467548 |doi=}}</ref>== | ||
Revision as of 12:59, 29 June 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.
Overview=
Bronchiectasis involves bronchi that are permanently dilated inflamed, and easily collapsible. This results in airflow obstruction and impaired clearance of secretions Cole's Cycle describes how infections and a defect in the host defense are factors for this disease. An immune response also plays a role in the pathogenesis.
Pathophysiology[1]
- Dilation of the bronchial walls results in airflow obstruction and impaired clearance of secretions
- The dilated areas interrupt normal air pressure of the bronchial tubes, causing sputum to pool inside the dilated areas instead of being pushed upward
- The pooled sputum provides an environment favorable to the growth of infectious pathogens
- The more infections that the lungs experience, the more damaged the alveoli in the lung become
- With more damage to the lung tissue, the bronchial tubes become more inelastic and dilated
- This creates a perpetual, destructive cycle
- The biopsies indicate that the infiltrate contains neutrophils, T lymphocytes and macrophages
- The sputum contains elastase, interleukin-8, tumor necrosis factor a (TNF-a), and prostanoids
Cole's Cycle[2]
- Also known as Cole's "vicious cycle hypothesis"
- The most widely known model of the development of bronchiectasis
- Impaired muco-ciliary clearance due to genetic susceptibility causes environmental insult
- Results in persistence of microbes in the sinobronchial tree
- The microbial infection causes chronic inflammation
- This results in tissue damage and impaired mucociliary motility
- This leads to more infection with a cycle of inflammation causing lung damage
- Two factors required for the development of this condition are persistent infection and a defect in host defense
Immune Response
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Schematic representation of a vicious circle of events which occurs during chronic bronchial infection. IL: interleukin; TNF: tumour necrosis factor; LT: leukotriene; MMP: matrix metalloproteinase
European Respiratory Journal
