• Jerome O Cantor and Gerard M Turino.
• Department of Pharmaceutical and Allied Health Sciences, St. John's University and St. Luke's-Mount Sinai Hospital Center, New York, NY. Electronic address: jocantor1@gmail.com.
• Chest. 2019 Feb 1; 155 (2): 266-271.

AbstractDeveloping an effective treatment for COPD, and especially pulmonary emphysema, will require an understanding of how fundamental changes at the molecular level affect the macroscopic structure of the lung. Currently, there is no accepted model that encompasses the biochemical and mechanical processes responsible for pulmonary airspace enlargement. We propose that pulmonary emphysematous changes may be more accurately described as an emergent phenomenon, involving alterations at the molecular level that eventually reach a critical structural threshold where uneven mechanical forces produce alveolar wall rupture, accompanied by advanced clinical signs of COPD. The coupling of emergent morphologic changes with biomarkers to detect the process, and counteract it therapeutically, represents a practical approach to the disease.Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

20 keywords...

hide…