By K. Ong
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Even with a higher prevalence of COPD related incidences in chronic bronchitis, mortality from emphysema (12,790) had exceeded that of chronic bronchitis (667) in pulmonary-related deaths  making early diagnosis and treatment of emphysema an alarming and continued cause for concern. 2. Pathogenesis of emphysema The pathogenesis of emphysema is embodied by enlargement of alveolar space, progressive destruction of connective tissue and loss of elasticity leading to eventual collapse of the small airways and destruction of pulmonary-alveolar units, all of which combine to limit gas exchange and airflow out of the lungs.
12] Finlay GA, O'Driscoll LR, Russell KJ, D'Arcy EM, Masterson JB, FitzGerald MX, O'Connor CM. Matrix metalloproteinase expression and production by alveolar macrophages in emphysema. Am J Respir Crit Care Med. 1997, 156(1):240-7.  Lim S, Roche N, Oliver BG, Mattos W, Barnes PJ, and Chung KF. Balance of matrix metalloprotease-9 and tissue inhibitor of metalloprotease-1 from alveolar macrophages in cigarette smokers. Am J Respir Crit Care Med 162: 1355–1360, 2000.  Atkinson JJ, Lutey BA, Suzuki Y, Toennies HM, Kelley DG, Kobayashi DK, Ijem WG, Deslee G, Moore CH, Jacobs ME, Conradi SH, Gierada DS, Pierce RA, Betsuyaku T, Senior RM.
356(23):2388-98 Gan WQ, Man SFP, Senthilselvan A et al. (2004). Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a metaanalysis. Thorax;59:574-580. Giusti B, Saracini C, Bolli P, Magi A, Sestini I, Sticchi E, Pratesi G, Pulli R, Pratesi C, Abbate R. (2008). Genetic analysis of 56 polymorphisms in 17 genes involved in methionine metabolism in patients with abdominal aortic aneurysm. ;45(11):721-30. Givvimani S, Qipshidze N, Tyagi N, Mishra PK, Sen U, Tyagi SC.