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Medical science has never been able to find a cure or even a way of preventing emphysema. The way to stop emphysema in its tracks, however, may be as simple as taking an aspirin a day.

Emphysema is an insidious disease. Now considered the same disease as chronic bronchitis, emphysema is the permanent, abnormal enlargement of the air spaces in the olungs known as bronchioles. When the bronchioles are too large, whether or not they are stiffened by scar tissue, they simply cannot "suck In' enough air to keep the bloodstream supplied with oxygen.

How Common Is Emphysema?

In the United States, about 5% of the population has been diagnosed with either emphysema or chornic bronchitis. Emphysema is 3-1/2 times more common in Oklahoma, the state that has the highest rate of the disease, than it is in Hawaii, the state that has the lowest. Worldwide, anywhere from 8.6 to 22.2 percent of men and 5.1 to 16.7 percent of women have the disease.
 

What Causes Emphysema?

In the North America, Australia, and Europe, the most common precursor of emphysema is smoking. Many smokers eventually develop emphysema. In the US, 15 to 20 percent of one  pack a day smoerks and 20 to 25 percent of two packs a day smokers get the disease.
 
In the rest of the world, however, the most common risk factor for emphysema is exposure to particulate air pollution. The most intense source of air pollution is not trucks, automobiles, or factories, but rather cooking fuels. Women who have to work with charcoal, animal manures, straw, or wood cookstoves or fireplaces are extremely likely to  develop chronic breathing problems.Any kind of exposure to dust increases the risk of the disease.
 
Genetics also makes a difference. Some people have one or two copies of a gene that codes the proteins for an enzyme inhibitor called alpha-1-antitrypsin, or AAT. In this case, it is an anti-enzyme that helps preserve health. AAT keeps tissue in the lungs from being broken down and replaced by scar tissue. Nonsmokers who ahve two copies of this gene almost enver develop emphysema, while smokers who do have either copy of the gene usually do.

What Happens In Emphysema?

The easiest way to explain emphysema is to liken it to the accumulation of a mass of scar tissue in the lungs. The linings of the lungs are exposed to noxious chemicals in cigarette smoke, cigar smoke, cooking fire smoke, dust, or industrial chemicals, the immune system sends white blood cells to remove the damage. 
The kind of white blood cells it sends, known as macrophages, are unusually large. Moreover, they communicate by a process known as chemotaxis to signal the immune system to send still more macrophages to get involved in the process. While these white blood cells are very efficient at removing dead lung cells, bacteria, dust, and particulate matter from smoke, they are relatively clumsy inside the tiny blood vessels that serve the lung. They get "stuck" and die. The immune system sends still more macrophages to remove the dead macrophages, and the second wave leads to a third, and so on. Eventually the delicate lining of an air sac is destroyed, and replaced by scar tissue. The scar tissue does not have the flexibility to receive a large amount of air, and less and less air gets into the bloodstream.
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