Centrilobular Emphysema: Causes, Symptoms, Treatment

Centrilobular Emphysema is a variant of COPD with the only difference from other forms of emphysema being the location of this being in the lungs. It is also known by the name of centriacinar emphysema and is seen mostly in chronic smokers above the age of 50. As the name suggests, Centrilobular Emphysema occurs right in the center of the functional part of the lungs. This area is called the secondary pulmonary lobules.^[1,2]

Epidemiology wise, Centrilobular Emphysema affects around 14 million people in the United States. This number includes around 15% active smokers and around 5% passive smokers. Centrilobular Emphysema is seen more in males than in females irrespective of the smoking history. Over time, Centrilobular Emphysema has been on an incline with more number of cases being reported every year.^[1,2]

The primary reason behind this considerable increase according to researchers is an increase in cigarette smoking and worsening environmental pollution. Genetics also play a role in determining the risk for Centrilobular Emphysema.^[1,2]

As stated, Centrilobular Emphysema is seen in smokers above the age of 50. The symptoms of Centrilobular emphysema may overlap with COPD. The chemicals present in cigarette smoke are absorbed by the lungs. It is these chemicals that cause inflammation, cause destruction of the air sacs, and make the immune system weak. The same theory goes for passive smokers as well.^[2]

There are other toxic chemicals present in the environment due to air pollution which is always on the rise which have the same effect on the lungs. People working in chemical factories are also exposed to such toxic chemicals which adversely affect the lungs causing Centrilobular Emphysema. Additionally, people working in the coal mines are also at risk for this condition.^[2]

Centrilobular Emphysema inflicts significant damage to the respiratory passages and affects normal airflow from the lungs. This condition affects the upper lobes in the center of the functioning units of the lungs. This is the reason why it becomes tough to breathe in people with Centrilobular Emphysema.^[2]

The symptoms of this condition are variable and depend on the overall health of a person and include problems carrying out activities of daily living due to breathing problems. The person will also have persistent cough due to damage to the upper lobes of the lungs. The cough will be productive of phlegm and mucous.^[2]

Additionally, the person will also experience chest tightness, wheezing, bluish discoloration of the lips and fingernails due to lack of adequate supply of oxygen. The symptoms tend to get worse as the disease progresses.^[2]

As of now, it is not possible to reverse the damage caused to the lungs by Centrilobular Emphysema. Therefore, the treatment is mainly symptomatic and focused on slowing down the progression of the disease. Acute flare up of symptoms further speeds up the progression of the disease with time. Some of these flares may be potentially serious and require inpatient treatment on an emergency basis. This forms the basis of treatment to prevent flares of Centrilobular Emphysema.^[2]

It is the severity of the symptoms that determines the treatment of Centrilobular Emphysema. These include^[2]

Inhalers: Corticosteroid inhalers are the frontline treatment for Centrilobular Emphysema. These medications calm down the inflammation and allow the person to breathe more normally. They also help in preventing flares of the condition. Bronchodilators are also quite effective in managing the symptoms of Centrilobular Emphysema. These medications dilate the airways and improve flow of air through the lungs thus improving the breathing.^[2]

While steroids are effective in the short term, bronchodilators can be used both short term as well as long term. In severe cases, both corticosteroids and bronchodilators are given in combination to control the symptoms of Centrilobular Emphysema.^[2]

Oxygen Therapy: Centrilobular Emphysema causes severe shortage of supply of oxygen to the vital organs of the body. This can be quite dangerous. Therefore, people are given oxygen supplementation so that adequate supply of oxygen is provided to the body and prevent any serious complications.^[2]

Some of the other treatment options include:

• Antibiotics to treat any infections present in the respiratory tract to control the symptoms
• Preventive vaccines so that any potential infections can be prevented in the lungs
• It is important to eat a healthy diet and prevent any inflammatory foods

In severe cases, a surgery may be required to remove the diseased portion of the lungs.^[2]

References: