Respiratory Pathology · Pathology

A 55-year-old smoker presents with centriacinar emphysema. Which protease-antiprotease imbalance is primarily responsible for this tissue destruction?

  1. Deficiency of alpha-1 antitrypsin
  2. Excessive release of elastase from neutrophils and macrophages
  3. Decreased production of surfactant by Type II pneumocytes
  4. Overproduction of mucus by goblet cells
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Correct answer: Excessive release of elastase from neutrophils and macrophages

Centriacinar emphysema is strongly associated with smoking, which triggers the recruitment of neutrophils and macrophages. These cells release elastase and other proteases that overwhelm local antioxidant defenses, leading to the destruction of alveolar walls.

Difficulty: Medium Question 2 of 20

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