GOLD Algorithm

00:00 Now, the GOLD algorithm that you want to keep in mind. So, the guidelines for lung disease and its algorithm puts you into two categories of pathogenesis. Asthma. Maybe there was a sensitizing agent that the patient was exposed to. Therefore, what kind of inflammatory mediators are then involved? These include CD4-T cells, lymphocytes, eosinophils, and may be perhaps interleukins 4 and 5. Now, all I am doing here is setting up the immunologic type of presentation of your patients with different types of COPD. Now, if it is COPD, this is a noxious agent that the patient has been exposed to versus the sensitising agent. The noxious agent would then result in a COPD airway inflammation and by definition, this is the T-lymphocyte CD8 cell and you might have CD68 which then represents your phagocytic cells either macrophages or polymorphonuclear cells, referring to neutrophils.

01:06 Now, this is a general overview of what you can expect with COPD, current day practice, and also how it’s divided in terms of type of cells that you are going to find between asthma and COPD. Remember, in the United States with asthma in a patient that has been smoking, often times, they will have overlapping signs and symptoms with whom? A patient that has chronic bronchitis. Take a look at the figure above or in previous discussion where we had specifically highlighted this issue. Subsequently, as you move further, we will get into our more exact pathology of COPD and we will begin our discussion in a little bit with emphysema.

01:51 See you then.