Pathogenic triad in COPD: oxidative stress, protease-antiprotease imbalance, and inflammation.
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2011
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Patients with chronic obstructive pulmonary disease (COPD) exhibit dominant features of chronic bronchitis, emphysema, and/or asthma, with a common phenotype of airflow obstruction. COPD pulmonary physiology reflects the sum of pathological changes in COPD, which can occur in large central airways, small peripheral airways, and the lung parenchyma. Quantitative or high-resolution computed tomography is used as a surrogate measure for assessment of disease progression. Different biological or molecular markers have been reported that reflect the mechanistic or pathogenic triad of inflammation, proteases, and oxidants and correspond to the different aspects of COPD histopathology. Similar to the pathogenic triad markers, genetic variations or polymorphisms have also been linked to COPD-associated inflammation, protease-antiprotease imbalance, and oxidative stress. Furthermore, in recent years, there have been reports identifying aging-associated mechanistic markers as downstream consequences of the pathogenic triad in the lungs from COPD patients. For this review, the authors have limited their discussion to a review of mechanistic markers and genetic variations and their association with COPD histopathology and disease status.
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Fischer, Bernard M, Elizabeth Pavlisko and Judith A Voynow (2011). Pathogenic triad in COPD: oxidative stress, protease-antiprotease imbalance, and inflammation. Int J Chron Obstruct Pulmon Dis, 6. pp. 413–421. 10.2147/COPD.S10770 Retrieved from https://hdl.handle.net/10161/13743.
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Elizabeth N Pavlisko
Dr. Pavlisko holds an undergraduate degree in Biochemistry from Clemson University and received her Doctor of Medicine from the Medical University of South Carolina. She completed her residency and is board certified in both Anatomic and Clinical Pathology. She trained as a pulmonary/thoracic pathology fellow at Duke University Medical Center under the mentorship of Drs. Victor Roggli and Thomas Sporn, two of the world’s leading Pulmonary Pathologist with expertise in pneumoconiosis and mesothelioma. She joined the faculty at Duke in 2011 as an Assistant Professor of Pathology, and her work is focused in thoracic, cardiovascular and transplant pathology as well as postmortem examination. Since starting her independent position, Dr. Pavlisko has developed expertise in neoplastic and non-neoplastic diseases of the lung and mediastinum with a special interest in lung transplantation and diseases of the pleura for which she is widely recognized as an authority. She currently serves as Chief of the Pulmonary/Thoracic Pathology Section.
Dr. Pavlisko’s clinical activities encompass pulmonary/thoracic and cardiovascular pathology, including transplantation, biomarker testing and autopsy pathology. Her primary research focus has centered on malignant mesothelioma and chronic lung allograft dysfunction (CLAD). She has published over 65 manuscripts and has 6 book chapters, the latter all centered on occupational diseases of the lungs and pleura. Since 2017, Dr. Pavlisko has co-chaired the lung steering committee for the Banff Foundation for Allograft Pathology. She is also an active member of the International Society for Heart and Lung Transplantation. Dr. Pavlisko has collaborations with the Departments of Pulmonary, Allergy and Critical Care Medicine and Cardiothoracic Surgery.
In addition to her clinical and research activities, Dr. Pavlisko is active in Duke University Hospital’s Clinical Laboratories and currently serves as the Medical Director of the Division of Anatomic Pathology and Digital Analytics (DAPDA) Laboratory, which includes Histology, Immunohistochemistry, FISH, and Image Analysis.
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