Nihon rinsho. Japanese journal of clinical medicine
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Apoptosis is a critical mechanism controlling cellularity in various tissues. It is so far unknown whether apoptosis plays a critical role in the pathogenesis and development of chronic obstructive pulmonary disease (COPD). However, recent evidence suggests that apoptosis may occur in vascular endothelial cells and/or alveolar epithelial cells in COPD lungs, thereby potentially contributing to lung tissue destruction seen in COPD. Apoptosis may also influence cellular infiltrates into the lung, another pathologic feature of COPD, because the survival of inflammatory cells such as neutrophils, lymphocytes, and macrophages are critically determined by the mechanism of apoptosis.
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The function of the cystic fibrosis (CF) gene product, cystic fibrosis transmembrane conductance regulator (CFTR) is critical to normal lung defense. CFTR not only acts as a cAMP-dependent Cl-channel, but regulates other ion channels and several cellular functions. ⋯ Only a few cases have been reported in Japanese with no mutations including delta F508 identified. Those cases seem to be caused by unknown factors yet to be found.
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Various pulmonary lesions can be found in patients with collagen vascular diseases. Not only the diseases but also treatment with various drugs relate to an occurrence of the pulmonary lesions such as infection, drug reaction, bronchiolitis and interstitial pneumonias. ⋯ Incidence of the interstitial pneumonias and diagnostic problems before biopsy using HRCT and BAL were evaluated. Comparison of interstitial pneumonias between idiopathic and associated with collagen vascular diseases is a problem to be solved.