COPD

Question 1

What are the two main pathologies which underlie COPD and contribute to restricted airflow?

Answer 1

Chronic Bronchitis - (damaged and increased airway thickness) - chronic inflammation and excess mucus production.
Emphysema - alveoli damage –> can’t exchnage as much oxygen –>

Question 2

Distinguish mild and severe COPD by spirometry.

Answer 2

Mild = FEV1/FVC < 0.7
FEV1 > 80% predicted.

Very Severe = FEV1/FVC = <0.7
FEV1 <30% predicted OR <50% predicted AND chronic repsiratory failure.

Question 3

What is GOLD and how has it been linked to NO?

Answer 3

characterization of COPD severity on basis of degree of airflow limitation measured during pulmonary function tests)
Brindicci et al in 2005 showed higher GOLD scores had increased alveolar NO.

Question 4

What does decreased telomere length indicate?

Answer 4

A marker for cell turnover, exposure to oxidative and inflammatory damage and biological age.

Question 5

How are inflammation and senescence thought to be linked?

Answer 5

Cytokines can be released from senescent cells.
IL-6 and IL-8 present in COPD lungs may induce maintenance of senescent phenotype - generating paracrine loops of cytokine secretion and activation of senescence in adjacent cells.

Question 6

What study probed steroid resistance in COPD?

Answer 6

Ito et al., (2005)
Found HDAC2 activity reduced in COPD patients. IL8 promoter activity also elevated compared to smokers and non-smokers. (ONOO- from smoke blocks HDAC2 –> more expression of inflammatory cytokines such as IL-8).