Chronic obstructive pulmonary disease (COPD) is the major cause of pulmonary disability in the United States and Europe.<sup>29 National Heart, Lung and Blood Institute, Division of Lung Disease Workshop Report The definition of emphysema American Review of Respiratory Disease 1985 ;  132 : 182-185

Cliccare qui per andare alla sezione Riferimenti</sup> Three disorders are incorporated in COPD: emphysema, peripheral airway disease, and chronic bronchitis. Any individual patient may have one or all of these conditions. Emphysema is defined as “a condition of the lung characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchiole, accompanied by destruction of their walls, and without obvious fibrosis.”<sup>29 National Heart, Lung and Blood Institute, Division of Lung Disease Workshop Report The definition of emphysema American Review of Respiratory Disease 1985 ;  132 : 182-185

Cliccare qui per andare alla sezione Riferimenti</sup> Specific guidelines for the diagnosis and care of patients with chronic obstructive pulmonary disease are given by the American Thoracic Society.<sup>3 American Thoracic Society Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma American Review of Respiratory Diseases Volume 1987 ;  136 (1) : 225-244

Cliccare qui per andare alla sezione Riferimenti</sup> The cardinal physiologic defect in emphysema is a decrease in elastic recoil of the lung tissue, which results in the principal physiologic abnormalities of emphysema: decreased maximum expiratory air flow, leading to air trapping and hyperinflation and severely limited exercise capacity.<sup>33 Potter W.A., Olafsson S., Hyatt R.E. Ventilatory mechanics and expiratory flow limitation during exercise in patients with obstructive lung disease J Clin Invest 1971 ;  50 : 910-919  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 38 Stubbing D.C., Pengelly L.D., Morse J.L.C. , e al. Pulmonary mechanics during exercise in subjects with chronic air flow obstruction J Appl Physiol 1980 ;  49 : 511-515

Cliccare qui per andare alla sezione Riferimenti</sup>The destruction of the alveolar-capillary membrane surface leads to a reduction in diffusing capacity.

Emphysema is usually the result of cigarette smoking, but also can be caused by ⍺₁-antitrypsin deficiency.<sup>13 Carrell R.W., Jeppsson J.O., Laurell C.B. , e al. Structure and variation of the human ⍺₁-antitrypsin Nature 1982 ;  298 : 329-334  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 24 Janus E.D., Phillips N.T., Carrell R.W. Smoking, lung function, and ⍺₁-antitrypsin deficiency Lancet 1985 ;  1 : 152-154  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> It is a chronic progressive disorder that ultimately leads to disability and early death. Emphysema is estimated to be present in 2 million adults in the United States, and, along with other forms of chronic obstructive pulmonary disease, accounts for about 90,000 deaths annually.