Summary: A pathological accumulation of air in tissues or organs.

Top Publications

  1. Matsuura H, Hartl D, Kang M, Dela Cruz C, Koller B, Chupp G, et al. Role of breast regression protein-39 in the pathogenesis of cigarette smoke-induced inflammation and emphysema. Am J Respir Cell Mol Biol. 2011;44:777-86 pubmed publisher
    ..We hypothesized that BRP-39/YKL-40 plays an important role in the pathogenesis of cigarette smoke (CS)-induced emphysema. To test this hypothesis, 10-week-old wild-type and BRP-39 null mutant mice (BRP-39(-/-)) were exposed to room ..
  2. Bai P, Sun Y, Jin J, Hou J, Li R, Zhang Q, et al. Disturbance of the OPG/RANK/RANKL pathway and systemic inflammation in COPD patients with emphysema and osteoporosis. Respir Res. 2011;12:157 pubmed publisher
    Osteoporosis is one of the systemic features of COPD. A correlation between the emphysema phenotype of COPD and reduced bone mineral density (BMD) is suggested by some studies, however, the mechanisms underlying this relationship are ..
  3. Lopes F, Pinto T, Arantes Costa F, Moriya H, Biselli P, Ferraz L, et al. Exposure to ambient levels of particles emitted by traffic worsens emphysema in mice. Environ Res. 2009;109:544-51 pubmed publisher
    We investigated effects of chronic exposure (2 months) to ambient levels of particulate matter (PM) on development of protease-induced emphysema and pulmonary remodeling in mice.
  4. Forey B, Thornton A, Lee P. Systematic review with meta-analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema. BMC Pulm Med. 2011;11:36 pubmed publisher
    Smoking is a known cause of the outcomes COPD, chronic bronchitis (CB) and emphysema, but no previous systematic review exists. We summarize evidence for various smoking indices.
  5. Mador M, Mogri M, Lewis M, Fournier M, Ray A, Michlin C, et al. Exercise capacity in hamsters with elastase-induced emphysema compared to normal controls. Respir Physiol Neurobiol. 2010;173:16-22 pubmed publisher
    The purpose of this study was to determine whether hamsters with elastase-induced emphysema (EMP) would demonstrate a reduction in exercise capacity compared to control (CON) hamsters and whether changes in activity levels, muscle ..
  6. Han M, Wise R, Mumford J, Sciurba F, Criner G, Curtis J, et al. Prevalence and clinical correlates of bronchoreversibility in severe emphysema. Eur Respir J. 2010;35:1048-56 pubmed publisher
    ..544 patients randomised to the medical arm of the National Emphysema Treatment Trial formed the study group...
  7. Wilson A, Murphy G, Hamakawa H, Kwok L, Srinivasan S, Hovav A, et al. Amelioration of emphysema in mice through lentiviral transduction of long-lived pulmonary alveolar macrophages. J Clin Invest. 2010;120:379-89 pubmed publisher
    ..in vivo is an attractive approach for both modulating gene expression and correcting inherited mutations such as emphysema caused by human alpha1 antitrypsin (hAAT) deficiency...
  8. Stolk J, Stockley R, Stoel B, Cooper B, Piitulainen E, Seersholm N, et al. Randomised controlled trial for emphysema with a selective agonist of the ?-type retinoic acid receptor. Eur Respir J. 2012;40:306-12 pubmed publisher
    Palovarotene is an oral ?-selective retinoid agonist. In animal emphysema models, palovarotene reduced inflammation, promoted structural repair and functional improvement...
  9. De Langhe E, Vande Velde G, Hostens J, Himmelreich U, Nemery B, Luyten F, et al. Quantification of lung fibrosis and emphysema in mice using automated micro-computed tomography. PLoS ONE. 2012;7:e43123 pubmed publisher
    ..This study aimed to develop and validate such an automated micro-computed tomography analysis algorithm for quantification of aerated lung volume in mice; an indicator of pulmonary fibrosis and emphysema severity.

Scientific Experts

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  1. Kim W, Hoffman E, Reilly J, Hersh C, DeMeo D, Washko G, et al. Association of COPD candidate genes with computed tomography emphysema and airway phenotypes in severe COPD. Eur Respir J. 2011;37:39-43 pubmed publisher
    The principal determining factors influencing the development of the airway disease and emphysema components of chronic obstructive pulmonary disease (COPD) have not been clearly defined...
  2. Alford S, van Beek E, McLennan G, Hoffman E. Heterogeneity of pulmonary perfusion as a mechanistic image-based phenotype in emphysema susceptible smokers. Proc Natl Acad Sci U S A. 2010;107:7485-90 pubmed publisher
    ..dysfunction and pathology of pulmonary vascular responses may serve as a precursor to smoking-associated emphysema. Although it is known that emphysematous destruction leads to vasculature changes, less is known about early ..
  3. Shan M, Cheng H, Song L, Roberts L, Green L, Hacken Bitar J, et al. Lung myeloid dendritic cells coordinately induce TH1 and TH17 responses in human emphysema. Sci Transl Med. 2009;1:4ra10 pubmed publisher
    ..The destruction of lung tissue that underlies smoking-induced emphysema has been associated with T helper 1 cells that recognize the matrix protein elastin...
  4. Wauters E, Smeets D, Coolen J, Verschakelen J, De Leyn P, Decramer M, et al. The TERT-CLPTM1L locus for lung cancer predisposes to bronchial obstruction and emphysema. Eur Respir J. 2011;38:924-31 pubmed publisher
    Clinical studies suggest that bronchial obstruction and emphysema increase susceptibility to lung cancer...
  5. Ito M, Hanaoka M, Droma Y, Kobayashi N, Yasuo M, Kitaguchi Y, et al. The association of Toll-like receptor 4 gene polymorphisms with the development of emphysema in Japanese subjects: a case control study. BMC Res Notes. 2012;5:36 pubmed publisher
    ..This resulted in increased oxidant generation and elastolytic activity, which led to pulmonary emphysema. It was suggested that TLR4 might maintain constitutive lung integrity by modulating oxidant generation...
  6. Martinez C, Chen Y, Westgate P, Liu L, Murray S, Curtis J, et al. Relationship between quantitative CT metrics and health status and BODE in chronic obstructive pulmonary disease. Thorax. 2012;67:399-406 pubmed publisher
    ..The authors hypothesised that QCT-defined emphysema and airway abnormalities relate to St George's Respiratory Questionnaire (SGRQ) and Body-Mass Index, Airflow ..
  7. Yasuo M, Mizuno S, Kraskauskas D, Bogaard H, Natarajan R, Cool C, et al. Hypoxia inducible factor-1? in human emphysema lung tissue. Eur Respir J. 2011;37:775-83 pubmed publisher
    ..study was to assess the expression of hypoxia inducible factor (HIF)-1? in lung tissue from patients with COPD/emphysema. Lung tissue samples from 26 patients were included in this study...
  8. Hanaoka M, Nicolls M, Fontenot A, Kraskauskas D, Mack D, Kratzer A, et al. Immunomodulatory strategies prevent the development of autoimmune emphysema. Respir Res. 2010;11:179 pubmed publisher
    ..presence of anti-endothelial cell antibodies and pathogenic T cells may reflect an autoimmune component in the pathogenesis of emphysema. Whether immune modulatory strategies can protect against the development of emphysema is not known.
  9. Mets O, Buckens C, Zanen P, Isgum I, van Ginneken B, Prokop M, et al. Identification of chronic obstructive pulmonary disease in lung cancer screening computed tomographic scans. JAMA. 2011;306:1775-81 pubmed publisher
    ..Smoking is a major risk factor for both cancer and chronic obstructive pulmonary disease (COPD). Computed tomography (CT)-based lung cancer screening may provide an opportunity to detect additional individuals with COPD at an early stage...
  10. Adir Y, Shachner R, Amir O, Humbert M. Severe pulmonary hypertension associated with emphysema: a new phenotype?. Chest. 2012;142:1654-1658 pubmed publisher
    ..Previous studies focusing specifically on patients with emphysema found that worsening PH was associated with progression of airflow obstruction...
  11. Harada H, Imamura M, Okunishi K, Nakagome K, Matsumoto T, Sasaki O, et al. Upregulation of lung dendritic cell functions in elastase-induced emphysema. Int Arch Allergy Immunol. 2009;149 Suppl 1:25-30 pubmed publisher
    ..Although dendritic cells (DCs) are thought to play a key role in immune responses, studies investigating the role of DCs in COPD are quite limited...
  12. Yasuo M, Mizuno S, Allegood J, Kraskauskas D, Bogaard H, Spiegel S, et al. Fenretinide causes emphysema, which is prevented by sphingosine 1-phoshate. PLoS ONE. 2013;8:e53927 pubmed publisher
    Sphingolipids play a role in the development of emphysema and ceramide levels are increased in experimental models of emphysema; however, the mechanisms of ceramide-related pulmonary emphysema are not fully understood...
  13. Cruz F, Antunes M, Abreu S, Fujisaki L, Silva J, Xisto D, et al. Protective effects of bone marrow mononuclear cell therapy on lung and heart in an elastase-induced emphysema model. Respir Physiol Neurobiol. 2012;182:26-36 pubmed publisher
    ..mononuclear cell (BMDMC) therapy protects the lung and consequently the heart in experimental elastase-induced emphysema. Twenty-four female C57BL/6 mice were intratracheally instilled with saline (C group) or porcine pancreatic ..
  14. Granato F, Voltolini L, Spina D, Paladini P, Gallazzi M, Gotti G. VATS for congenital lobar emphysema: a case report. Minerva Chir. 2009;64:111-5 pubmed
    Congenital lobar emphysema (CLE) is a rare congenital lung disease consisting in overinflation of a pulmonary lobe. Adult onset of CLE is therefore unusual, often presented with mild symptoms...
  15. Wielpütz M, Weinheimer O, Eichinger M, Wiebel M, Biederer J, Kauczor H, et al. Pulmonary emphysema in cystic fibrosis detected by densitometry on chest multidetector computed tomography. PLoS ONE. 2013;8:e73142 pubmed publisher
    ..on lung specimens from patients with cystic fibrosis (CF) and recent results from a mouse model indicate that emphysema may contribute to CF lung disease. However, little is known about the relevance of emphysema in patients with CF...
  16. Hesselbacher S, Ross R, Schabath M, Smith E, Perusich S, Barrow N, et al. Cross-sectional analysis of the utility of pulmonary function tests in predicting emphysema in ever-smokers. Int J Environ Res Public Health. 2011;8:1324-40 pubmed publisher
    b>Emphysema is largely an under-diagnosed medical condition that can exist in smokers in the absence of airway obstruction...
  17. Tzouvelekis A, Zacharis G, Oikonomou A, Mikroulis D, Margaritopoulos G, Koutsopoulos A, et al. Increased incidence of autoimmune markers in patients with combined pulmonary fibrosis and emphysema. BMC Pulm Med. 2013;13:31 pubmed publisher
    Combined pulmonary fibrosis and emphysema (CPFE) is an umbrella term encompassing upper lobe emphysema and lower lobe pulmonary fibrosis with pathogenesis elusive...
  18. Ley Zaporozhan J, van Beek E. Imaging phenotypes of chronic obstructive pulmonary disease. J Magn Reson Imaging. 2010;32:1340-52 pubmed publisher
    ..The comprehensive diagnostic possibilities of CT complemented by MRI will allow for a more sensitive detection, phenotype-driven characterization, and dedicated therapy monitoring of the disease...
  19. Katsha A, Ohkouchi S, Xin H, Kanehira M, Sun R, Nukiwa T, et al. Paracrine factors of multipotent stromal cells ameliorate lung injury in an elastase-induced emphysema model. Mol Ther. 2011;19:196-203 pubmed publisher
    ..However, although MSCs reduce destruction in an elastase-induced lung emphysema model, MSC differentiation is relatively rare, suggesting that MSC differentiation into specific cells does not ..
  20. Cho M, Washko G, Hoffmann T, Criner G, Hoffman E, Martinez F, et al. Cluster analysis in severe emphysema subjects using phenotype and genotype data: an exploratory investigation. Respir Res. 2010;11:30 pubmed publisher
    ..One reason may be heterogeneity in disease definition. Unsupervised learning approaches may assist in understanding disease heterogeneity...
  21. Stinn W, Buettner A, Weiler H, Friedrichs B, Luetjen S, van Overveld F, et al. Lung inflammatory effects, tumorigenesis, and emphysema development in a long-term inhalation study with cigarette mainstream smoke in mice. Toxicol Sci. 2013;131:596-611 pubmed publisher
    ..Data from this study suggest that the A/J mouse model holds considerable promise as a relevant model for investigating smoking-related emphysema and adenocarcinoma development.
  22. Mizuno S, Yasuo M, Bogaard H, Kraskauskas D, Alhussaini A, Gomez Arroyo J, et al. Copper deficiency induced emphysema is associated with focal adhesion kinase inactivation. PLoS ONE. 2012;7:e30678 pubmed publisher
    ..Cell detachment from the extracellular matrix can induce apoptosis (anoikis) via inactivation of focal adhesion kinase (FAK)...
  23. Bastarrika G, Wisnivesky J, Pueyo J, Díaz L, Arraiza M, Villanueva A, et al. Low-dose volumetric computed tomography for quantification of emphysema in asymptomatic smokers participating in an early lung cancer detection trial. J Thorac Imaging. 2009;24:206-11 pubmed publisher
    High-resolution computed tomography (CT) is a validated method to quantify the extent of pulmonary emphysema. In this study, we assessed the reliability of low-dose volumetric CT (LDCT) for the quantification of emphysema and its ..
  24. Chen K, Pociask D, McAleer J, Chan Y, Alcorn J, Kreindler J, et al. IL-17RA is required for CCL2 expression, macrophage recruitment, and emphysema in response to cigarette smoke. PLoS ONE. 2011;6:e20333 pubmed publisher
    ..Remarkably, in contrast to WT mice, IL-17RA(-/-) mice failed to develop emphysema after 6 months of cigarette smoke exposure...
  25. Oliveira P, Menezes A, Bertoldi A, Wehrmeister F. Inhaler use in adolescents and adults with self-reported physician-diagnosed asthma, bronchitis, or emphysema in the city of Pelotas, Brazil. J Bras Pneumol. 2013;39:287-95 pubmed publisher
    To evaluate the characteristics of users of inhalers and the prevalence of inhaler use among adolescents and adults with self-reported physician-diagnosed asthma, bronchitis, or emphysema.
  26. Coxson H, Dirksen A, Edwards L, Yates J, Agusti A, Bakke P, et al. The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: a prospective analysis from the ECLIPSE study. Lancet Respir Med. 2013;1:129-36 pubmed publisher
    b>Emphysema is a key contributor to airflow limitation in chronic obstructive pulmonary disease (COPD) and can be quantified using CT scanning...
  27. Timmins S, Diba C, Farrow C, Schoeffel R, Berend N, Salome C, et al. The relationship between airflow obstruction, emphysema extent, and small airways function in COPD. Chest. 2012;142:312-319 pubmed publisher
    The severities of COPD (FEV(1) % predicted) and airflow obstruction (FEV(1)/FVC) are considered to be due to both emphysema and small airways disease...
  28. Gooptu B, Ekeowa U, Lomas D. Mechanisms of emphysema in alpha1-antitrypsin deficiency: molecular and cellular insights. Eur Respir J. 2009;34:475-88 pubmed publisher
    The severe, early onset emphysema that occurs in patients with circulating deficiency of alpha(1)-antitrypsin (alpha(1)-AT) attests to the importance of this protease inhibitor in maintaining lung parenchymal integrity...
  29. Artaechevarria X, Blanco D, de Biurrun G, Ceresa M, Pérez Martín D, Bastarrika G, et al. Evaluation of micro-CT for emphysema assessment in mice: comparison with non-radiological techniques. Eur Radiol. 2011;21:954-62 pubmed publisher
    ..potential, limitations and synergies of micro-CT and other non-radiological techniques for the quantification of emphysema and related processes in mice, by performing a complete characterization of the elastase-induced emphysema model.
  30. Zhang X, Pang B, Hou X, Wang J, Wang C. Oxidative stress and peripheral skeletal muscle dysfunction in rats with emphysema. Chin Med J (Engl). 2010;123:40-4 pubmed
    ..The purpose of this study was to investigate whether local oxidative stress is associated with the reduced peripheral skeletal muscle performance in rats with emphysema.
  31. Barr R, Ahmed F, Carr J, Hoffman E, Jiang R, Kawut S, et al. Subclinical atherosclerosis, airflow obstruction and emphysema: the MESA Lung Study. Eur Respir J. 2012;39:846-54 pubmed publisher
    ..The affected vascular bed and contribution of emphysema to cardiovascular risk are unclear...
  32. Gan G, Hu R, Dai A, Tan S, Ouyang Q, Fu D, et al. The role of endoplasmic reticulum stress in emphysema results from cigarette smoke exposure. Cell Physiol Biochem. 2011;28:725-32 pubmed publisher
    Apoptosis is of considerable importance in the pathogenesis of emphysema, and recent studies show that endoplasmic reticulum (ER) stress is involved in emphysema...
  33. Rangasamy T, Misra V, Zhen L, Tankersley C, Tuder R, Biswal S. Cigarette smoke-induced emphysema in A/J mice is associated with pulmonary oxidative stress, apoptosis of lung cells, and global alterations in gene expression. Am J Physiol Lung Cell Mol Physiol. 2009;296:L888-900 pubmed publisher
    ..Chip arrays to determine the temporal alterations in global gene expression during the progression of pulmonary emphysema in A/J mice...
  34. Shan M, Yuan X, Song L, Roberts L, Zarinkamar N, Seryshev A, et al. Cigarette smoke induction of osteopontin (SPP1) mediates T(H)17 inflammation in human and experimental emphysema. Sci Transl Med. 2012;4:117ra9 pubmed publisher
    ..We have shown that CD1a+ antigen-presenting cells (APCs) from lungs of patients with emphysema can induce autoreactive T helper 1 (T(H)1) and T(H)17 cells...
  35. Stockley R, Parr D, Piitulainen E, Stolk J, Stoel B, Dirksen A. Therapeutic efficacy of ?-1 antitrypsin augmentation therapy on the loss of lung tissue: an integrated analysis of 2 randomised clinical trials using computed tomography densitometry. Respir Res. 2010;11:136 pubmed publisher
    Two randomised, double-blind, placebo-controlled trials have investigated the efficacy of IV alpha-1 antitrypsin (AAT) augmentation therapy on emphysema progression using CT densitometry.
  36. Mets O, Schmidt M, Buckens C, Gondrie M, Isgum I, Oudkerk M, et al. Diagnosis of chronic obstructive pulmonary disease in lung cancer screening Computed Tomography scans: independent contribution of emphysema, air trapping and bronchial wall thickening. Respir Res. 2013;14:59 pubmed publisher
    ..Therefore, this study aims to determine the independent diagnostic value of CT emphysema, CT air trapping and CT bronchial wall thickness for COPD in low-dose screening CT scans.
  37. Ryerson C, Hartman T, Elicker B, Ley B, Lee J, Abbritti M, et al. Clinical features and outcomes in combined pulmonary fibrosis and emphysema in idiopathic pulmonary fibrosis. Chest. 2013;144:234-240 pubmed publisher
    Combined pulmonary fibrosis and emphysema (CPFE) is increasingly recognized, but its prevalence and prognosis remain unclear...
  38. Schleede S, Meinel F, Bech M, Herzen J, Achterhold K, Potdevin G, et al. Emphysema diagnosis using X-ray dark-field imaging at a laser-driven compact synchrotron light source. Proc Natl Acad Sci U S A. 2012;109:17880-5 pubmed publisher
    In early stages of various pulmonary diseases, such as emphysema and fibrosis, the change in X-ray attenuation is not detectable with absorption-based radiography...
  39. Akira M, Inoue Y, Kitaichi M, Yamamoto S, Arai T, Toyokawa K. Usual interstitial pneumonia and nonspecific interstitial pneumonia with and without concurrent emphysema: thin-section CT findings. Radiology. 2009;251:271-9 pubmed publisher
    To determine whether concurrent emphysema influences the distinction between usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP) at thin-section computed tomography (CT).
  40. Zhang H, Chen P, Zeng H, Zhang Y, Peng H, Chen Y, et al. Protective effect of demethylation treatment on cigarette smoke extract-induced mouse emphysema model. J Pharmacol Sci. 2013;123:159-66 pubmed
    In the present study, we explored the effects of demethylation in a cigarette smoke extract (CSE)-induced mouse emphysema model...
  41. D Armiento J, Goldklang M, Hardigan A, Geraghty P, Roth M, Connett J, et al. Increased matrix metalloproteinase (MMPs) levels do not predict disease severity or progression in emphysema. PLoS ONE. 2013;8:e56352 pubmed publisher
    ..This study aimed to determine whether bronchoalveolar lavage (BALF) or plasma MMP measurements correlated with disease severity or functional decline in emphysema.
  42. Guarnieri F, Spencer J, Lucey E, Nugent M, Stone P. A human surfactant peptide-elastase inhibitor construct as a treatment for emphysema. Proc Natl Acad Sci U S A. 2010;107:10661-6 pubmed publisher
    Two million Americans suffer from pulmonary emphysema, costing $2.5 billion/year and contributing to 100,000 deaths/year...
  43. Lehman A, Mattman A, Sin D, Pare P, Zong Z, D AZZO A, et al. Emphysema in an adult with galactosialidosis linked to a defect in primary elastic fiber assembly. Mol Genet Metab. 2012;106:99-103 pubmed publisher
    ..b>Emphysema has not been previously reported as a possible complication of this disorder, but we now describe this condition ..
  44. Gorbunova V, Jacobs S, Lo P, Dirksen A, Nielsen M, Bab Hadiashar A, et al. Early detection of emphysema progression. Med Image Comput Comput Assist Interv. 2010;13:193-200 pubmed
    b>Emphysema is one of the most widespread diseases in subjects with smoking history. The gold standard method for estimating the severity of emphysema is a lung function test, such as forced expiratory volume in first second (FEV1)...
  45. Schmidt S, Nambiar A, Tayob N, Sundaram B, Han M, Gross B, et al. Pulmonary function measures predict mortality differently in IPF versus combined pulmonary fibrosis and emphysema. Eur Respir J. 2011;38:176-83 pubmed publisher
    ..was derived to represent the extent of fibrosis on high-resolution computed tomography (HRCT), adjusting for emphysema in patients with idiopathic pulmonary fibrosis (IPF)...
  46. Zhang W, Zhang Y, Cui Y, Rong W, Cambier C, Devillier P, et al. Can ?2-adrenoceptor agonists, anticholinergic drugs, and theophylline contribute to the control of pulmonary inflammation and emphysema in COPD?. Fundam Clin Pharmacol. 2012;26:118-34 pubmed publisher
    ..effects of these bronchodilators but their protective role against chronic inflammation and the development of emphysema in patients with COPD remains to be investigated...
  47. Foronjy R, Imai K, Shiomi T, Mercer B, Sklepkiewicz P, Thankachen J, et al. The divergent roles of secreted frizzled related protein-1 (SFRP1) in lung morphogenesis and emphysema. Am J Pathol. 2010;177:598-607 pubmed publisher
    ..SFRP1, an inhibitor of Wnt signaling normally expressed during lung embryogenesis, is induced in the lungs of emphysema patients and in two murine models of the disease...
  48. Koshiol J, Rotunno M, Consonni D, Pesatori A, De Matteis S, Goldstein A, et al. Chronic obstructive pulmonary disease and altered risk of lung cancer in a population-based case-control study. PLoS ONE. 2009;4:e7380 pubmed publisher
    ..Chronic obstructive pulmonary disease (COPD) has been consistently associated with increased risk of lung cancer. However, previous studies have had limited ability to determine whether the association is due to smoking...
  49. Cheng D, Kim D, Cockayne D, Belousov A, Bitter H, Cho M, et al. Systemic soluble receptor for advanced glycation endproducts is a biomarker of emphysema and associated with AGER genetic variants in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2013;188:948-57 pubmed publisher
    b>Emphysema in chronic obstructive pulmonary disease (COPD) can be characterized by high-resolution chest computed tomography (HRCT); however, the repeated use of HRCT is limited because of concerns regarding radiation exposure and cost.
  50. Chong D, Brown M, Kim H, van Rikxoort E, Guzman L, McNitt Gray M, et al. Reproducibility of volume and densitometric measures of emphysema on repeat computed tomography with an interval of 1 week. Eur Radiol. 2012;22:287-94 pubmed publisher
    The reproducibilities of CT lung volume and densitometric measures of emphysema were assessed over 1 week. The influence of breathhold on reproducibility was assessed.
  51. Lee J, Hanaoka M, Kitaguchi Y, Kraskauskas D, Shapiro L, Voelkel N, et al. Imbalance of apoptosis and cell proliferation contributes to the development and persistence of emphysema. Lung. 2012;190:69-82 pubmed publisher
    ..Whereas lung cell apoptosis has been recognized in human emphysema, little is known about cell proliferation.
  52. Mohamed Hoesein F, Zanen P, de Jong P, van Ginneken B, Boezen H, Groen H, et al. Rate of progression of CT-quantified emphysema in male current and ex-smokers: a follow-up study. Respir Res. 2013;14:55 pubmed publisher
    Little is known about the factors associated with CT-quantified emphysema progression in heavy smokers...
  53. Matsuoka S, Washko G, Dransfield M, Yamashiro T, San Jose Estepar R, Diaz A, et al. Quantitative CT measurement of cross-sectional area of small pulmonary vessel in COPD: correlations with emphysema and airflow limitation. Acad Radiol. 2010;17:93-9 pubmed publisher
    ..suggest that vascular alteration is closely related to endothelial dysfunction and may be further influenced by emphysema. However, the relationship between morphological alteration of small pulmonary vessels and the extent of ..