The Protease Anti-Protease Hypothesis

The protease-antiprotease hypothesis of emphysema pathogenesis has been widely accepted for many years, however, few visualizations of this disease attempt to explain this enzymatic imbalance. Rather, most depictions of emphysema focus entirely on the gross anatomical damage and loss of elasticity resulting from the inhalation of harmful substances.

This illustration elucidates the specific cellular activity responsible for this damage. Since the underlying cause for alveolar breakdown is an immune-mediated response that incurs the destruction of the elastic-extracellular matrix, this illustration clearly highlights this relationship and relates it to the gross pathology of emphysema.