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26 - Obstructive pulmonary disease

Published online by Cambridge University Press:  17 August 2009

By
Bipen D. Patel  and
David A. Lomas
Edited by
Alan Wright  and
Nicholas Hastie
Alan Wright
Affiliation:
MRC Human Genetics Unit, Edinburgh
Nicholas Hastie
Affiliation:
MRC Human Genetics Unit, Edinburgh
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Summary

Introduction

Obstructive pulmonary disease describes a heterogeneous group of diseases which are characterized by airflow obstruction on expiration. This is defined as a forced expiratory volume in one second (FEV1) of less than 80% predicted with a ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) of less than 70%. Asthma and chronic obstructive pulmonary disease (COPD) account for the vast majority of the global disease burden from obstructive pulmonary disease and these two conditions will be the focus of this chapter.

Asthma

Asthma is an inflammatory condition of the airways which results in bronchial reactivity to a variety of stimuli with consequent narrowing of the airways. This results in airflow obstruction which is usually reversible (National Heart, Lung, and Blood Institute, 1992; Department of Health and Social Services, 2003). The cardinal features of airway inflammation, bronchial hyper-reactivity and reversible airflow obstruction give rise to the symptoms of wheeze, breathlessness, cough and chest tightness which are usually the basis for the diagnosis of asthma. Although these symptoms are not specific, the hallmark for the diagnosis of asthma is their intermittent nature, reversibility, diurnal variation and the recognition of specific triggers (British Thoracic Society; Scottish Intercollegiate Guidelines Network, 2003). Asthma is strongly associated with atopy as demonstrated by the link with eczema and hay fever and the detection of IgE, or a positive skin prick test, to a specific allergen (Witt et al., 1986; Woolcock et al., 1987).

Type
Chapter
Information
Genes and Common Diseases
Genetics in Modern Medicine
 , pp. 391 - 405
Publisher: Cambridge University Press
Print publication year: 2007

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