Clinical Strategy of Chronic Obstructive Pulmonary Disease in the Elderly

Chronic obstructive pulmonary disease (COPD) is a disease involving either or both of chronic bronchitis and emphysema. In the elderly, bronchial asthma is usually called chronic asthma because of sustained asthma attachs and resistance to therapy. Although the absolute value of IgE is low in the as...

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Published inNihon Rōnen Igakkai zasshi Vol. 30; no. 12; pp. 999 - 1004
Main Authors Sasaki, Hidetada, Sekizawa, Kiyoshisa
Format Journal Article
LanguageJapanese
Published Japan The Japan Geriatrics Society 1993
Subjects
Aged
Allergy
Asthma - immunology
Bronchitis - immunology
Chronic asthma
Chronic bronchitis
Emphysema
Female
Histamine methyl-transferase
Histamine N-Methyltransferase - metabolism
Humans
Immunoglobulin E - analysis
Lung Diseases, Obstructive - diagnosis
Lung Diseases, Obstructive - immunology
Male
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Summary:Chronic obstructive pulmonary disease (COPD) is a disease involving either or both of chronic bronchitis and emphysema. In the elderly, bronchial asthma is usually called chronic asthma because of sustained asthma attachs and resistance to therapy. Although the absolute value of IgE is low in the asthma in the elderly, IgE values correlated to the symptoms of asthma in the elderly. Therefore, asthma in the elderly is supposed to be primarily caused by allergic reactions. Airway epithelium products histamine methyl-transferase (HMT) and cholinesterase. Allergic reactions and/or virus infection in the airway epithelium reduce productions of these enzymes, which exacerbate bronchoconstriction. Steroid hormons increase these engymes and relieve bronchoconstriction. Silent aspiration may exacerbate asthma attack in the night and recurrent cough and sputum in COPD. Macrolide antibiotics relieve chronic infections in the elderly. Plural constriction against bullae using thoracoscopy reduce dyspnea drematically in emphysema.
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ISSN:0300-9173
DOI:10.3143/geriatrics.30.999