Emphysema Introduction

:emphysema.gif Emphysema belongs in the group of diseases referenced as Chronic Obstructive Pulmonary Diseases (COPD). This category also includes such diseases as asthma and chronic bronchitis. Emphysema is characterized by both the destruction of the walls within the lung, and with the lung tissue loosing its elastic recoil. This degradation results in the enlargement of the air spaces within the lung and provides for inefficient ventilation.

The main risk factors for developing Emphysema include; cigarette smoking, hyperesponsive airways, exposure to air pollution, and a genetic deficiency of an enzyme called alpha-1 antitrypsin. [1]

Emphysema Symptoms

  • Onset of Chronic Obstructive Pulmonary Disease tends to be slow and usually manifests as a productive cough at the ages between 40 to 50.
  • Emphysema that is due to alpha-1 antitrypsin deficiency tends to manifest earlier in life than emphysema due to other causes such as cigarette smoking.
  • Findings upon a physical examination of Chronic Obstructive Pulmonary Disease patients may be non remarkable in the earlier stages, contributing to the advanced age and stage at which the disease is diagnosed.
  • Coughing up of blood in any patient with Chronic Obstructive Pulmonary Disease, accompanied with a history of cigarette smoking, requires the ruling out of possible cancer of the lung.

Emphysema Statistics

  • In 1994 there were 16 million Americans affected by various forms of Chronic Obstructive Pulmonary Disease.
  • It is estimated that Chronic Obstructive Pulmonary Diseases will become the third leading cause of death by the year 2020.
  • The incidence and mortality due to Chronic Obstructive Pulmonary Diseases increase with increasing age and is more prevalent in males and Caucasian populations. Chronic Obstructive Pulmonary Disease also have higher mortality rates in populations with less education and among blue collar workers. [2, 3]

Emphysema Treatment

Standard treatment for Emphysema involves numerous components, many of which aim at treating the various sequelae that can come from Chronic Obstructive Pulmonary Diseases. Smoking cessation is first and foremost important action in the treatment of Emphysema. Setting a quit date, the application of transdermal nicotine patches, and behavioral therapy are all useful strategies for attaining the goal of quitting the use of tobacco. Patients with Emphysema are considered to be in a high risk group for purposes of influenza infection and should receive a flu vaccination every year. A pneumococcal vaccine should also be considered. Pharmacological treatments for Emphysema are aimed at alleviating symptoms and may include; bronchodialators and oxygen to improve shortness of breath, Theophylline to reduce spasms, and antibiotics can help prevent and treat lung infections that can be common in patients with Chronic Obstructive Pulmonary Diseases. [5]

Supplements helpful for Emphysema

N-Acetyl Cysteine N- acetyl Cysteine serves as the precursor for glutathione, which is one of the main antioxidants in the body and is vital for health. N-Acetyl Cysteine is more stable and readily absorbed by the body than the amino acid it is derived from-cysteine.

In the treatment of Emphysema, N-Acetyl Cysteine can serve a number of purposes. It can act as a direct scavenger of reactive oxygen species that have been implicated in the pathogenesis of Emphysema. N-Acetyl Cysteine also serves as the precursor for Glutathione (see below), and also has the effect of thinning mucus secretions that are often prevalent in Chronic Obstructive Pulmonary Diseases. N-acetyl Cysteine has been demonstrated to be effective in protecting lung tissue from damage induced by environmental insults such as cigarette smoke. The beneficial effects of N-acetyl Cysteine appear to be enhanced by the concurrent use of a selenium-containing heterocycle compound. [6, 7, 8]


Glutathione Glutathione is an antioxidant compound that is composed of 3 amino acids: cysteine, glutamine, and glycine. Glutathione is one of the main antioxidants that occurs in the body and is used to prevent damage to both cell membranes and genetic material. Glutathione also functions to help keep other antioxidant systems in a reduced state so that they can perform their protective antioxidant functions. It is believed that high glutathione levels may protect lung tissues from the damaging effects of cigarette smoke on alveolar macrophages.

The availability of glutathione that is taken orally is uncertain and it is considered more available in a nebulized form. For this reason, it is considered more effective to take the precursor to glutathione, N-acetyl cysteine, orally. In the pathogenesis of Emphysema there seems to be and imbalance between oxidants and antioxidants in the lung tissues. This imbalance is exacerbated by environmental insults such as cigarette smoke and air pollution. Nebulized Glutathione has been successfully used to avert an acute respiratory crisis caused by Emphysema. It has also been shown to improve the course of the chronic disease process. [10, 11, 12]

Other Antioxidants In imbalance of oxidants and antioxidants in the lung tissues is one of the major factors that can contribute to the pathogenesis of Emphysema. It has been demonstrated that exposure to both primary and secondary cigarette smoke increases the oxidative stress that is placed on lung tissues. Even though the lungs are considered an internal organ, they are constantly exposed to the outside environment in the form of the gases that are introduced to the lung with every breath.

The lungs are equipped with numerous defenses to prevent damage to their sensitive tissues. Among the lungs’ defenses are antioxidant systems that serve to protect the various cells in the lungs from damage. When the antioxidant defenses are overwhelmed, the “door” is then opened for development of such diseases as Emphysema. It is important to ensure that the balance of antioxidants to oxidants remains high in the lungs to help improve lung condition and prevent further damage. [14, 15, 16, 18]

Usage: Emphysema treatment should include a multivitamin that contains adequate doses of antioxidant vitamins including; Vitamin E, Vitamin C, Copper, Zinc, beta-carotene (only after smoking cessation has been achieved), Selenium, and Manganese.


[1] Beers and Berkow, The Merck Manual (Whitehouse NJ: Merck Research Laboratories, 1999), 568-79.

[2] Beers and Berkow, The Merck Manual (Whitehouse NJ: Merck Research Laboratories, 1999), 568-79.

[3] Groneberg DA, Chung KF. Models of chronic obstructive pulmonary disease. Respir Res. 2004 Nov 2;5(1):18

[4] Beers and Berkow, The Merck Manual (Whitehouse NJ: Merck Research Laboratories, 1999), 568-79.

[5] Groneberg DA, Chung KF. Models of chronic obstructive pulmonary disease. Respir Res. 2004 Nov 2;5(1):18

[6] Cotgreave IA, Moldeus P. Lung protection by thiol-containing antioxidants. Bull Eur Physiopathol Respir. 1987 Jul-


[7] Moldeus P, Cotgreave IA, Berggren M. Lung protection by a thiol-containing antioxidant: N-acetylcysteine. Respiration. 1986;50 Suppl 1:31-42.

[8] Goldberg, Gitomer, Abel, The Best Supplements for Your Health (New York NY: Twin Streams, 2002), 222.

[9] Gaby A, Nutritional Therapy in Medical Practice, (self published, 2001) , 90-91

[10] Lamson DW, Brignall MS. The use of nebulized glutathione in the treatment of emphysema: a case report. Altern Med Rev. 2000 Oct;5(5):429-31.

[11] Gressier B, Lebegue S, Gosset P, Brunet C, Luyckx M, Dine T, Cazin M, Cazin JC, Wallaert B. Protective role of glutathione on alpha 1 proteinase inhibitor inactivation by the myeloperoxidase system. Hypothetic study for therapeutic strategy in the management of smokers’ emphysema. Fundam Clin Pharmacol. 1994;8(6):518-24.

[12] Buhl R, Meyer A, Vogelmeier C.Oxidant-protease interaction in the lung. Prospects for antioxidant therapy. Chest. 1996 Dec;110(6 Suppl):267S-272S.

[13] Gaby A, Nutritional Therapy in Medical Practice, (self published, 2001) , 90-91

[14] Yildiz L, Kayaoglu N, Aksoy H. The changes of superoxide dismutase, catalase and glutathione peroxidase activities in erythrocytes of active and passive smokers. Clin Chem Lab Med. 2002 Jun;40(6):612-5.

[15] Machlin LJ, Bendich A. Free radical tissue damage: protective role of antioxidant nutrients. FASEB J. 1987 Dec;1(6):441-5.

[16] Cantin A, Crystal RG. Oxidants, antioxidants and the pathogenesis of emphysema. Eur J Respir Dis Suppl. 1985;139:7-17.

[17] Rahman I, MacNee W. Role of oxidants/antioxidants in smoking-induced lung diseases. Free Radic Biol Med. 1996;21(5):669-81.

[18] Menzel DB. Antioxidant vitamins and prevention of lung disease. Ann N Y Acad Sci. 1992 Sep 30;669:141-55.


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