OBSTRUCTIVE PULMONARY DISEASE

DEFINITION OF THE DISEASE

OPD (obstructive pulmonary disease) is a inflammatory lung disease that causes

obstructed airflow from the lungs, it also refers to a group of diseases that cause
airflow blockage and breathing-related problems. It includes emphysema and chronic
bronchitis. It's typically caused by long-term exposure to irritating gases or particulate
matter, most often from cigarette smoke. Its presence is associated with shorter
survival rates and it has been identified as a predictive factor of worse clinical
outcomes and frequent use of health resources.

EPIDEMIOLOGY AND RISK FACTORS

OPD is a major and increasing global health problem, which is predicted to

become the third commonest cause of death and the fifth commonest cause of
disability in the world by 2020.

Epidemiology and risk factors of OPD is attributed to the total burden of toxic
gases and particles that individuals inhale during their lifetime.Although atmospheric
pollution contributes to this burden, the smoking of tobacco products is the major risk
factor. The host defence system against this type of insult is provided by the innate
and adaptive inflammatory and immune response. It is agreed by consensus that an
estimated number of 210 million people have OPD worldwide. Overall, the
prevalence of COPD in the general population is estimated to be around 1% across all
ages, rising steeply to 8–10% or higher among those aged 40 years or older.

OPD is a chronic inflammatory lung disease that causes obstructed airflow from
the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production
and wheezing. People with obstructive lung disease have shortness of breath due to
difficulty exhaling all the air from the lungs. Because of damage to the lungs or
narrowing of the airways inside the lungs, exhaled air comes out more slowly than
normal.Subsequent to that date, even assuming the most pessimistic scenario
regarding the global spread of human immunodeficiency/acquired immune deficiency
virus, by 2030, OPD will be the direct underlying cause of 7.8% of all deaths, and
represent 27% of deaths related with smoking, only surpassed by 33% for cancer and
29% by cardiovascular disease.

PATHOPHYSILOGY

 This starts with damage to the airways and tiny air sacs in the lungs. Symptoms
progress from a cough with mucus to difficulty breathing. The damage done by
OPD can't be undone.

 is based on the innate and adaptive inflammatory immune response to the

inhalation of toxic particles and gases.
  Abnormalities in gas transfer occur due to reduced airflow/ventilation and as
a result of loss of alveolar structure and pulmonary vascular bed.

Figure 1: Anatomical features of the innate and adaptive inflflammatory immune responses

(A) Migration of inflflammatory cells in the epithelial layer (white arrows) and entry into the surface mucous layer of a guineapig after exposure to cigarette smoke. (B) Histology of bronchial
microvasculature. One capillary bed lies between the epithelium and muscle (single arrow) and a second lies in the adventitial compartment below outside the muscle (double arrow). These two capillary beds
are joined by connecting vessels (arrow head) that pass between the muscle bundles. (C) Lymphoid follicle in BALT with a germinal centre (GC). The follicle is covered by a specialised epithelium
containing M cells (between the arrows), which transport antigens from the lumen into the subepithelial tissue. (D) Diagram of a regional lymph node, which differs from BALT in that it has afferent
lymphatic vessels that penetrate a capsule surrounding the node and an efferent lymphatic vessel that leaves at the hilum. The blood supply to the follicle forms a network around the outer edge of the follicles
in both lymph nodes and BALT. The vessels that form this network around the follicles located in BALT arise from the outer vascular plexus shown in (B).

SYMTOMPS

 increasing breathlessness – this may only happen when exercising at first, and
you may sometimes wake up at night feeling breathless.
 a persistent chesty cough with phlegm that does not go away.
 frequent chest infections.
 persistent wheezing.

TREATMENT

 short-acting bronchodilator inhalers are the first treatment used.

 Quit smoking
 Medications
 Surgery
 Lung therapies