Smoker's Lung: Pathology Photo Essay (cont.)
What happens to the airways in chronic bronchitis?
In chronic bronchitis, smoke damages the cells that line the airway
(epithelial cells). Nicotine is one of the many components of cigarette smoke
that is directly toxic to the lining cells of the airway. (Of course, the
nicotine is also addictive.) The tissue damage attracts inflammatory cells.
These cells then release enzymes that further damage the lining cells of the
airway and stimulate goblet cells to increase in number and to increase mucus
production. Figure 6 is
a microscopic section of a bronchial wall in a smoker with chronic bronchitis.
Figure 6: BRONCHIAL WALL IN CHRONIC BRONCHITIS
The major consequence of chronic bronchitis is airway obstruction. In fact,
this figure demonstrates mucus and debris blocking the bronchial airway. Indeed,
the most important cause of airway obstruction in chronic bronchitis is blockage
by mucus, inflammation, progressive scarring (fibrosis), and/or narrowing
(constriction) of the airways. As a result of the bronchial blockage, gases
cannot get to and from the alveoli. In other words, chronic bronchitis
interferes with ventilation.
It is important to know that people with
asthma likewise have chronic
bronchitis with airway obstruction. In asthma, however, the cause of obstruction
is somewhat different and the obstruction usually occurs in attacks that are
reversible. In any case, both smokers and asthmatics with bronchitis may cough,
wheeze, and spit up thick mucus (sputum) from the lung.
Next: Are smokers with COPD predisposed to developing pneumonia? »
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