COPD and aging of the lungs

Question 1

What are the 3 phenotypes of COPD?

Answer 1

1. chronic bronchitis
2. Emphysema
3. airway obstruction (can be asthma)

Question 2

What can be a epigenetic alteration that causes COPD?

Answer 2

mutation in the SERPINA1 gene –> causes AAT deficiency.

Question 3

What is alpha-1-antitrypsin?

Answer 3

it is a serine protease inhibitor of neutrophil-derived proteases. (protects the lungs from proteases in easy words)

Question 4

What are some riskfactors of COPD?

Answer 4

• infections
• osteoporosis
• depression
• muscle depletion
• smoking
• prenatal events
• cardiovascular disease
• physical inactivity

Question 5

How do we test whether someone has COPD

Answer 5

• Pulmonary function test, the spirometry test
• Chest X-ray
• CT scan
• arterial blood gas analysis
• laboratory test

Question 6

What does the spirometry test measure?

Answer 6

it measures how much air you can breath out in one forced breath. This is stated in FEV

Question 7

What stages are there of COPD?

Answer 7

1. mild: FVC is already under 70%, FEV is still normal
2. moderate FVC under 70% and FEV 50%-70%
3. severe FVC under 70% and FEV 30%-50%
4. Very severe FVC under 70% and FEV under 30%

Question 8

What are the treatments of COPD?

Answer 8

• smoking cessation: just stop with smoking
• vaccination: lessens the risk of infections
• physical activity
• Pharmacotherapy (LABA and LAMA)
• oxygen and ventilatory support
• lung transplantation
• Bullectomy

Question 9

What happens in a bullectomy?

Answer 9

Damaged air sacs that are combined in the lungs are called bullae, these are removed to make room for the healthy air sacs

Question 10

What happens in the respiratory epithelium during aging?

Answer 10

reduced mucociliary clearance in both upper and lower airways

Question 11

What happens with the lung progenitor cells during aging?

Answer 11

• most common aging due to stem cell exhaustion
• rates of bronchiolar club cell-self renewal and differentiation were reduced
• functional tissue regeneration is reduced
• reduction of Wnt signalling

Question 12

What happens with the interstitium during aging?

Answer 12

integrity and concentration changes, this negatively affect cells of the lungs

Question 13

What happens in general with the T-lymphocytes during aging?

Answer 13

• there is a decrease in naïve T-cell numbers
• decrease in T-cell helper response

Question 14

What happens in general with the NK cell during aging?

Answer 14

• decreased function
• decreased antiviral responses

Question 15

What happens in general with the alveolar macrophages during aging?

Answer 15

• decrease in phagocytosis
• increased superoxide production

Question 16

What happens with alveolar epithelial cells during aging in general?

Answer 16

• increase in reactive oxidative stress
• increase apoptosis and senescence

Question 17

What is COPD exacerbations?

Answer 17

increased in symptoms that is larger thatn the day-day variations and requires adjustments in medications

Question 18

What are the symptoms of exacerbation?

Answer 18

• increased cough
• more and sticky mucus
• increased shortness of breath

Question 19

What is SASP?

Answer 19

Senescent associated Secretory phenotype, these cells secrete high levels of inflammatory cytokines, immune modulators, proteases etc.