Smoking is the leading cause of emphysema
A.allergy, Neurodermitis and
A.sthahilfe Thuringia e.V.
The clinical picture
Pulmonary emphysema is a pathological overinflation of the lungs. A distinction is made between sudden (acute), curable pulmonary emphysema in an asthma attack and chronic emphysema, which usually occurs as a result of chronic bronchitis or chronic obstructive bronchitis, especially in smokers over the age of 50. Very rarely it is a congenital enzyme defect (alpha-1 proteinase inhibitor deficiency) that leads to emphysema in people under 40 years of age.
Depending on the cause, an acute and a chronic form of pulmonary emphysema can be distinguished.
Acute emphysema is a reversible pulmonary flatulence that occurs when smaller bronchi have narrowed during an asthma attack. The cause of chronic emphysema is assumed to be an imbalance between the destructive and protective enzymes in the alveoli.
During inflammatory processes in the lungs, enzymes that break down tissue are released from granulocytes (white blood cells used for defense). Excessive reactions are prevented by a neutralizing enzyme circulating in the blood called an alpha-1 proteinase inhibitor (formerly known as alpha-1 antitrypsin). People with a congenital alpha-1 proteinase inhibitor deficiency therefore develop severe pulmonary emphysema. However, this hereditary enzyme deficiency is very rare (approx. 1-2% of all cases).
The most common cause of chronic emphysema is smoking.
Cigarette smoke contains substances that inactivate the alpha-1 proteinase inhibitor. In addition, smokers are more susceptible to infections. Frequent inflammation of the bronchi leads to chronic bronchitis. Also typical is the morning cough after getting up, during which foul-smelling phlegm is secreted, the so-called "smoker's cough". As a result of the expansion of the air spaces, the elasticity of the lungs gradually decreases over several years, which leads to an overstretching of the lungs with reduced blood flow and an irreversible loss of lung tissue.
Dust pollution, a number of chemical substances, pressure loads e.g. B. with professional musicians (wind instruments) or glass blowers, fine dust occurs e.g. in coal mining, in quarries, ore mines or as organic mixed dust such as animal feed, raw cotton or flax. The chemical causes of the disease include aluminum, beryllium, cadmium, mustard, etc.
Smoking is a major risk. It is therefore important that those affected give up smoking permanently.
Favoring factors are divided into exogenous (external) factors and endogenous (internal) factors.
- Exogenous factors are smoking and occupational damage from dust. Passive smoking, viral and bacterial infections and environmental pollution also have a positive effect.
- Endogenous factors are alpha-1 antitrypsin deficiency and cystic fibrosis.
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