Why does emphysema develop?

Causes of Primary Emphysema

Emphysema is primary and secondary. Bronchial obstruction in primary emphysema is a complication of the pathological process, and secondary emphysema complicates the course of chronic bronchitis.
The causes of primary diffuse emphysema are: hereditary deficiency of alpha-antitrypsin, exposure to tobacco smoke and aggressive environmental factors, as well as a number of occupational hazards, including mechanical stretching of lung tissue.
Genetically determined deficiency of the enzyme alpha-antitrypsin leads to the activation of proteolysis and damage to the alveolar walls, which later ends with the development of emphysema.
Smoking is the most aggressive environmental factor, ranking first in the development of chronic lung obstruction, including emphysema. Prolonged exposure to tobacco smoke leads to the migration of neutrophils in the final sections of the respiratory tract, increased production of proteolytic enzymes that destroy the elastic base of the alveoli.Resins accumulating in macrophages reduce the production of alpha-antitrypsin.
Pollutants are aggressive environmental factors that damage the airways, the alveolar walls of the lungs, which leads to the development of emphysema. The most pronounced pathogenic effects are sulfur and nitrogen oxides, black smoke, and ozone. The mechanism of their action is damage to the alveolar membranes, activation of proteolytic enzymes in the bronchopulmonary system, destruction of the lung skeleton, and increased release of inflammatory mediators into the blood.

Causes of secondary emphysema

Secondary emphysema is divided into several clinical forms with different causes of education.
Infant lobar emphysema is a disease characterized by emphysematous lesion of one lobe of the lung due to atelectasis in the other lobes. Occurs in young children.
Near-circumferential pulmonary emphysema is a pathology that develops around foci of previous sarcoidosis, tuberculosis or pneumonia. Near-circumference emphysema affects mainly the tops of the lungs.
Unilateral emphysema develops in place of unilateral bronchitis or bronchiolitis, suffered in childhood.
Paraseptal emphysema complicates the course of focal bronchitis or bronchiolitis.It is formed in the lung tissue adjacent to the pleura or connective tissue septa.

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