What Causes Emphysema? A Complete Student Guide
Emphysema is the lung condition which involves damage to the walls of the air sacs medically known as Alveoli. Alveoli are small, thin-walled and very fragile, located in clusters at the end of the bronchial tubes deep inside lungs. On average there are about 280-300 million alveoli in normal lungs, they play the most vital role in the respiratory process. It is where the interchange of oxygen and carbon-di-oxide takes place. Both chronic bronchitis and Emphysema fall into the sect of chronic obstructive pulmonary disease (COPD). The term ‘obstructive’ is used as they both hinder the smooth interchange of oxygen and carbon-di-oxide in the lungs causing shortness of breath. The major cause of Emphysema is smoking; a person can develop Emphysema after many years of inhaling polluted air.
Emphysema Causes
Most of the Emphysema patients have been found related to smoking in some sort or another, over the years. Air pollutants in-home or work-space, genetic factors and other respiratory infections also play a part in causing Emphysema. Statistics show that over 3 million people have been diagnosed with Emphysema in the US, and more than 11 million people have chronic obstructive pulmonary disease. Emphysema is one of the most preventable diseases as it relates to smoking; an early halt to smoking can prevent Emphysema. Cigarettes also destroy the lung tissues and also block the airways, causing inflammation. As the lung swells up, the amount of exchanged air is reduced, causing obstruction in breathing. Also, the bronchioles over-inflate due to the inflammation of the lungs, the diaphragm gets compressed.
Other Risk Factors Involved for Emphysema include the Following:
Continuous exposure to high pollution chemical irritants and lung pollutants
A genetic condition produced due to deficiency of alpha-1 deficiency that can lead to a rare form of Emphysema called alpha-1 deficiency related Emphysema.
History of repeated childhood infections of the respiratory system
A weak immune system especially in children suffering from other immunocompromised conditions
Suffering from rare disorders such as Marfan Syndrome
Emphysema Symptoms
There are some key symptoms of Emphysema that necessitates a thorough diagnosis. Such Emphysema symptoms include coughing, wheezing, shortness of breath, inflated chest, chest tightness, excessive mucus production. Emphysema symptoms can be misunderstood as a minor ailment. Some of the other symptoms include-
You may feel shortness of breath while working out, even during light exercise.
There may be a continuous feeling of not getting enough air.
Fatigue
Excessive mucus production.
Coughing, especially experiencing smoker’s cough
Your chest may look rounded or inflated
Coughing up stained phlegm, usually yellow or red in color.
Weight loss
Difficulty sleeping
Types of Emphysema
There are three types of Emphysema - Centriacinar Emphysema, panacinar Emphysema and paraseptal Emphysema.
Centriacinar Emphysema- In this condition, the alveoli and airways of the central acinus are affected. The respiratory bronchioles and alveolar ducts are destroyed.
Panacinar Emphysema- Panacinar Emphysema damages the whole acinus.
Paraseptal Emphysema- In this condition patients are known to acquire the pulmonary bullous disease.
Stages of Emphysema
The stages of Emphysema are based on different factors such as airflow limitation, symptoms, and exacerbations. A breathing test can be done to measure lung capacity. The test helps to know the forced expiratory volume in 1 second (FEV1)
The stages of Emphysema are given based on FEV1:
Stage 1 or Very Mild Stage: FEV1 is about 80% of normal.
Stage 2 or Moderate: FEV1 is 50-80% of normal.
Stage 3 or Severe: FEV1 is 30-50% of normal.
Stage 4 or Very Severe: FEV1 is less than 30% of normal.
The stages only help to determine the condition of the person but it cannot help to predict for how long a person can survive. Doctors can prescribe other tests and diagnostic procedures to find out more about the severity of the person’s condition.
Emphysema Diagnostic Procedures and Prevention
Emphysema falls under the COPD umbrella, and this cannot be cured, but if diagnosed, treatments can help to slow the progression of the disease. As the disease is mostly caused by smoking, it can be prevented beforehand by simply giving up on the whole idea of smoking cigarettes. In the case of polluted air in the work-space, wearing a mask can benefit hugely. Bronchodilators, inhaled steroids, antibiotics are some of the treatments that doctors suggest to Emphysema patients. There are also some therapeutic procedures, such as pulmonary rehabilitation, nutrition therapy, or supplemental oxygen. Depending on the severity of Emphysema, one may have to go under surgery. Lung volume reduction surgery and lung transplantation are viable options. Physiotherapy can also help in increasing the exercise capacity, mobility and self-confidence of Emphysema patients.
Did You know?
Statistics show that over 3 million people have been diagnosed with Emphysema in the US, and more than 11 million people have COPD. People between the ages of 50-70 are most common Emphysema patients. Though deadly, this disease can be prevented as it is linked to smoking. Around 480,000 people are killed each year in the US for smoking. And 80% of those deaths are due to COPD, which includes Emphysema.
Solved Examples
1. What are the Emphysema Symptoms?
Ans: There are some key symptoms of Emphysema that necessitates a thorough diagnosis. Such symptoms include coughing, wheezing, shortness of breath, inflated chest, chest tightness, excessive mucus production.
2. What are the types of Emphysema and describe them in short?
Ans: There are three types of Emphysema- Centriacinar Emphysema, panacinar Emphysema and paraseptal Emphysema. In Centriacinar Emphysema the alveoli and airways of the central acinus are affected while Panacinar Emphysema affects the whole central acinus. Paraseptal Emphysema is the third type of this lung condition which leads to various pulmonary diseases.
3. Give some tips to manage Emphysema.
Ans: A few tips are given here that can help people to manage the symptoms of Emphysema and prevent further complications:
Wash your hands regularly before eating food
Brush and floss your teeth two times a day and rinse your mouth with an antibacterial mouth rinse after meals.
Keep the breathing equipment clean
Use a vacuum clear to keep your house clean and free from dust
Get a flu shot every year to prevent allergic reactions
Use the treatment and medicines suggested by your doctor
Avoid irritants such as vehicle fumes, cigarette smoke, strong perfumes, dust, pollen, pet dander, etc.
FAQs on Emphysema: Key Facts, Symptoms & Biology Insights
1. What is emphysema as defined in the biology syllabus?
Emphysema is a chronic, long-term respiratory disorder characterised by the damage and over-inflation of the alveoli (air sacs) in the lungs. This damage leads to the breakdown of the alveolar walls, which significantly reduces the surface area available for the exchange of oxygen and carbon dioxide, leading to breathing difficulties. It is a major type of Chronic Obstructive Pulmonary Disease (COPD).
2. What are the primary causes of emphysema?
The most common cause of emphysema is long-term exposure to airborne irritants. The key causes include:
- Cigarette Smoking: This is the leading cause, as the chemicals in tobacco smoke damage the elastic fibres in the lungs.
- Air Pollution: Prolonged exposure to fumes, dust, and other industrial pollutants can also contribute to the disease.
- Genetic Factors: A rare hereditary condition known as alpha-1-antitrypsin (AAT) deficiency can cause emphysema, even in non-smokers, as this protein protects the elastic structures in the lungs.
3. What are the major symptoms of emphysema that students should know?
The primary symptom of emphysema is shortness of breath (dyspnea), which usually begins gradually and worsens over time. Other common symptoms include a chronic cough (often with mucus), wheezing, a feeling of tightness in the chest, and reduced capacity for physical activity.
4. How does cigarette smoke biologically cause the alveolar damage seen in emphysema?
Cigarette smoke contains harmful chemicals that trigger a chronic inflammatory response in the lungs. This inflammation attracts immune cells that release enzymes, such as elastase, which break down elastin. Elastin is a crucial protein that gives the alveolar walls their elasticity and allows them to recoil during exhalation. The progressive destruction of elastin causes the alveolar walls to rupture, merging small air sacs into larger, inefficient ones and trapping air.
5. Why is shortness of breath the main symptom of emphysema?
Shortness of breath occurs in emphysema for two main physiological reasons. Firstly, the destruction of alveolar walls decreases the total surface area for gas exchange, making it harder for oxygen to enter the bloodstream. Secondly, the loss of lung elasticity causes airways to collapse during exhalation, trapping stale air in the lungs. This makes it difficult to fully exhale and take in fresh, oxygen-rich air, creating a constant feeling of breathlessness.
6. What is the key difference between emphysema and chronic bronchitis?
While both are types of COPD, they affect different parts of the respiratory system. Emphysema is primarily a disease of the alveoli (air sacs), where the walls are destroyed. In contrast, chronic bronchitis is a disease of the bronchial tubes (airways), characterised by inflammation and excessive mucus production, which obstructs airflow.
7. Can emphysema be cured or reversed?
No, the damage to the lung tissue caused by emphysema is permanent and irreversible. The destroyed alveolar walls cannot be repaired. However, treatments and significant lifestyle changes, especially quitting smoking, can help manage symptoms, improve quality of life, and critically slow down the progression of the disease.
8. What is the pathophysiology of emphysema?
The pathophysiology of emphysema involves the progressive destruction of the lung parenchyma, specifically the terminal bronchioles and alveoli. The primary mechanism is an imbalance between proteases (like elastase) and antiproteases (like alpha-1-antitrypsin). In smokers, chronic inflammation increases protease activity, which degrades the elastic fibres of the alveolar walls. This leads to a loss of elastic recoil, permanent enlargement of airspaces, and a decreased surface area for gas exchange, ultimately impairing respiratory function.
