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'{{short description|Disease of the respiratory system}} {{Infobox medical condition (new) | name = Respiratory disease | synonyms = | image = Emphysema_low_mag.jpg | caption = [[Micrograph]] of an emphysematous lung; [[emphysema]] is a common respiratory disease, strongly associated with [[smoking]]. [[H&E stain]]. | pronounce = | field = [[Pulmonology]] | geneReviewsName2= | geneReviewsName3= | geneReviewsName4= | geneReviewsName5= | geneReviewsName6= | geneReviewsName7= | | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} '''Respiratory diseases''', or '''lung diseases''',<ref>{{Cite web|url=https://meshb.nlm.nih.gov/record/ui?ui=D008171|title=Lung diseases|website=MeSH.nlm.nih.gov|access-date=14 August 2019}}</ref> are [[pathology|pathological]] conditions affecting the organs and tissues that make [[gas exchange]] difficult in [[Breathing|air-breathing]] animals. They include conditions of the [[respiratory tract]] including the [[trachea]], [[bronchi]], [[bronchioles]], [[Pulmonary alveolus|alveoli]], [[pulmonary pleurae|pleurae]], [[pleural cavity]], the nerves and [[muscles of respiration]]. Respiratory diseases range from mild and self-limiting, such as the [[common cold]], [[influenza]], and [[pharyngitis]] to life-threatening [[disease]]s such as [[bacterial pneumonia]], [[pulmonary embolism]], [[tuberculosis]], [[Asthma|acute asthma]], [[lung cancer]],<ref>{{cite journal | vauthors = Sengupta N, Sahidullah M, Saha G | title = Lung sound classification using cepstral-based statistical features | journal = Computers in Biology and Medicine | volume = 75 | issue = 1 | pages = 118–29 | date = August 2016 | pmid = 27286184 | doi = 10.1016/j.compbiomed.2016.05.013 }}</ref> and [[severe acute respiratory syndrome]]s, such as [[Coronavirus disease 2019|COVID-19]].<ref>{{cite journal | vauthors = | title = COVID-19 and vascular disease | journal = EBioMedicine | volume = 58 | pages = 102966 | date = August 2020 | pmid = 32829782 | pmc = 7438984 | doi = 10.1016/j.ebiom.2020.102966 }}</ref> Respiratory diseases can be classified in many different ways, including by the organ or tissue involved, by the type and pattern of associated signs and symptoms, or by the cause of the disease. The study of respiratory disease is known as [[pulmonology]]. A [[physician]] who specializes in respiratory disease is known as a pulmonologist, a chest medicine specialist, a respiratory medicine specialist, a respirologist or a thoracic medicine specialist. ==Obstructive lung disease== [[Asthma]], [[Bronchitis#Chronic bronchitis|chronic bronchitis]], [[bronchiectasis]] and [[chronic obstructive pulmonary disease]] (COPD) are all [[obstructive lung disease]]s characterised by [[airway obstruction]]. This limits the amount of air that is able to enter alveoli because of constriction of the bronchial tree, due to inflammation. Obstructive lung diseases are often identified because of symptoms and diagnosed with [[pulmonary function tests]] such as [[spirometry]]. Many obstructive lung diseases are managed by avoiding triggers (such as [[dust mite]]s or [[smoking]]), with symptom control such as [[bronchodilator]]s, and with suppression of inflammation (such as through [[corticosteroid]]s) in severe cases. One common cause of COPD including [[emphysema]], and chronic bronchitis, is [[tobacco smoking]], and common causes of [[bronchiectasis]] include severe infections and [[cystic fibrosis]]. The definitive cause of [[asthma]] is not yet known.<ref>{{cite book | vauthors = Reid PT, Innes JA | chapter = Respiratory Diseases | veditors = Walker BR, Colledge NR, Ralston SH, Penman I |title=Davidson's Principles and Practice of Medicine |date=2014 |isbn=978-0-7020-5035-0 | publisher = Elsevier Health Sciences |pages=661–730 |edition=22nd }}</ref> ==Restrictive lung diseases== [[File:Respiratory diseases world map - DALY - WHO2004.svg|thumb|[[Age adjustment|Age-standardised]] [[disability-adjusted life year]] (DALY) rates from respiratory diseases by country (per 100,000 inhabitants).]] [[Restrictive lung disease]]s are a category of respiratory disease characterized by a loss of [[Pulmonary compliance|lung compliance]],<ref name="emedicineRLD">{{cite web | vauthors = Sharma S | date = 5 June 2006 | veditors = Grier LR, Ouellette DR, Mosenifar Z |url= http://www.emedicine.com/med/topic2012.htm | archive-url = https://web.archive.org/web/20081219183106/https://emedicine.medscape.com/article/301760-overview | archive-date = 19 December 2008 |title= Restrictive Lung Disease | work = Medscape |access-date=2008-04-19 }}</ref> causing incomplete lung expansion and increased lung stiffness, such as in infants with respiratory distress syndrome. Restrictive lung diseases can be divided into two categories: those caused by intrinsic factors and those caused by extrinsic factors. Restrictive lung diseases yielding from intrinsic factors occur within the lungs themselves, such as [[tissue death]] due to inflammation or toxins. Conversely, restrictive lung diseases caused by extrinsic factors result from conditions originating from outside the lungs such as [[Neuromuscular disease|neuromuscular dysfunction]] and irregular chest wall movements.<ref>{{cite book | vauthors = Martinez-Pitre PJ, Sabbula BR, Cascella M | chapter = Restrictive Lung Disease|date=2020 |url=http://www.ncbi.nlm.nih.gov/books/NBK560880/| title = StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=32809715|access-date=2020-12-04}}</ref> ==Chronic respiratory disease== Chronic respiratory diseases (CRDs) are long-term diseases of the airways and other structures of the lung. They are characterized by a high inflammatory cell recruitment ([[Neutrophil granulocyte|neutrophil]]) and/or destructive cycle of [[infection]], (e.g. mediated by ''[[Pseudomonas aeruginosa]]''). Some of the most common are [[asthma]], [[chronic obstructive pulmonary disease]], and [[acute respiratory distress syndrome]]. CRDs are not curable; however, various forms of treatment that help dilate major air passages and improve [[shortness of breath]] can help control symptoms and increase the quality of life.<ref>{{Cite web | url=https://www.who.int/respiratory/en/ | work = World Health Organization | title = Chronic respiratory diseases (CRDs)}}</ref> '''Telerehabilitation for chronic respiratory disease''' The latest evidence suggests that primary pulmonary rehabilitation and maintenance rehabilitation delivered through telerehabilitation for people with chronic respiratory disease reaches outcomes similar to centre-based rehabilitation.<ref name=":7">{{cite journal | vauthors = Cox NS, Dal Corso S, Hansen H, McDonald CF, Hill CJ, Zanaboni P, Alison JA, O'Halloran P, Macdonald H, Holland AE | display-authors = 6 | title = Telerehabilitation for chronic respiratory disease | journal = The Cochrane Database of Systematic Reviews | volume = 1 | issue = 1 | pages = CD013040 | date = January 2021 | pmid = 33511633 | pmc = 8095032 | doi = 10.1002/14651858.CD013040.pub2 | collaboration = Cochrane Airways Group }}</ref> While there are no safety issues identified, the findings are based on evidence limited by a small number of studies.<ref name=":7" /> ==Respiratory tract infections== Infections can affect any part of the respiratory system. They are traditionally divided into upper respiratory tract infections and lower respiratory tract infections. ===Upper respiratory tract infection=== The most common [[upper respiratory tract infection]] is the [[common cold]]. However, infections of specific organs of the upper respiratory tract such as [[sinusitis]], [[tonsillitis]], [[otitis media]], [[pharyngitis]] and [[laryngitis]] are also considered upper respiratory tract infections. ===Lower respiratory tract infection=== The most common lower respiratory tract infection is [[pneumonia]], an infection of the lungs which is usually caused by bacteria, particularly ''[[Streptococcus pneumoniae]]'' in Western countries. Worldwide, [[tuberculosis]] is an important cause of pneumonia. Other pathogens such as viruses and fungi can cause pneumonia for example [[severe acute respiratory syndrome]], [[COVID-19]] and [[pneumocystis pneumonia]]. Pneumonia may develop complications such as a lung abscess, a round cavity in the lung caused by the infection, or may spread to the [[pleural cavity]]. Poor oral care may be a contributing factor to lower respiratory disease. as bacteria from gum disease may travel through airways and into the lungs.<ref>{{cite web|url=https://www.unitedconcordia.com/dental-insurance/dental/conditions/respiratory-disease-oral-health/|title=Respiratory Disease & Oral Health |work=United Concordia Companies, Inc }}</ref><ref name="pmid21523216">{{cite journal | vauthors = Gomes-Filho IS, Passos JS, Seixas da Cruz S | title = Respiratory disease and the role of oral bacteria | journal = Journal of Oral Microbiology | volume = 2 | issue = | date = December 2010 | page = 5811 | pmid = 21523216 | pmc = 3084574 | doi = 10.3402/jom.v2i0.5811 }}</ref> ==Tumors== === Malignant tumors === Malignant tumors of the respiratory system, particularly [[lung cancer|primary carcinomas of the lung]], are a major health problem responsible for 15% of all cancer diagnoses and 30% of all cancer deaths. The majority of respiratory system cancers are attributable to [[tobacco smoking|smoking tobacco]]. The major [[histology|histological]] types of respiratory system cancer are: * [[Small cell lung cancer]] * [[Non-small cell lung cancer]] ** Adenocarcinoma of the lung ** Squamous cell carcinoma of the lung ** Large cell lung carcinoma * Other lung cancers ([[carcinoid]], [[Kaposi’s sarcoma]], [[melanoma]]) * [[Lymphoma]] * [[Head and neck cancer]] * [[Pleural]] [[mesothelioma]], almost always caused by exposure to [[asbestos]] dust. In addition, since many cancers spread via the bloodstream and the entire cardiac output passes through the lungs, it is common for cancer [[metastases]] to occur within the lung. [[Breast cancer]] may invade directly through local spread, and through lymph node metastases. After metastasis to the [[liver cancer|liver]], [[colon cancer]] frequently metastasizes to the lung. [[Prostate cancer]], germ cell cancer and [[renal cell carcinoma]] may also metastasize to the lung. Treatment of respiratory system cancer depends on the type of cancer. Surgical removal of part of a lung ([[lobectomy]], [[segmentectomy]], or [[wedge resection]]) or of an entire lung [[pneumonectomy]]), along with chemotherapy and [[radiotherapy]], are all used. The chance of surviving lung cancer depends on the cancer stage at the time the cancer is diagnosed, and to some extent on the [[histology]], and is only about 14–17% overall. In the case of metastases to the lung, treatment can occasionally be curative but only in certain, rare circumstances. ===Benign tumors=== Benign tumors are relatively rare causes of respiratory disease. Examples of benign tumors are: * Pulmonary [[hamartoma]] * Congenital malformations such as [[pulmonary sequestration]] and [[congenital cystic adenomatoid malformation]] (CCAM). ==Pleural cavity diseases== Pleural cavity diseases include [[pleural|pleural mesothelioma]] which are mentioned above. A collection of fluid in the pleural cavity is known as a [[pleural effusion]].<ref name=":0">{{cite journal | vauthors = Karkhanis VS, Joshi JM | title = Pleural effusion: diagnosis, treatment, and management | journal = Open Access Emergency Medicine | volume = 4 | pages = 31–52 | date = 2012-06-22 | pmid = 27147861 | pmc = 4753987 | doi = 10.2147/OAEM.S29942 }}</ref> This may be due to fluid shifting from the bloodstream into the pleural cavity due to conditions such as congestive heart failure and cirrhosis.<ref name=":0" /> It may also be due to inflammation of the pleura itself as can occur with infection, [[pulmonary embolus]], tuberculosis, mesothelioma and other conditions.<ref name=":0" /> A [[pneumothorax]] is a hole in the pleura covering the lung allowing air in the lung to escape into the pleural cavity. The affected lung "collapses" like a deflated balloon. A [[tension pneumothorax]] is a particularly severe form of this condition where the air in the pleural cavity cannot escape, so the pneumothorax keeps getting bigger until it compresses the heart and blood vessels, leading to a life-threatening situation. ==Pulmonary vascular disease== Pulmonary vascular diseases are conditions that affect the [[pulmonary circulation]]. Examples are:{{Citation needed|reason=please give a reliable source.|date=September 2008}} * [[Pulmonary embolism]], a [[Thrombosis|blood clot]] that forms in a vein, breaks free, travels through the heart and lodges in the lungs (thromboembolism). Large pulmonary emboli are fatal, causing sudden death. A number of other substances can also embolise (travel through the blood stream) to the lungs but they are much more rare: [[fat embolism]] (particularly after bony injury), amniotic fluid embolism (with complications of labour and delivery), [[air embolism]] ([[iatrogenic]] – caused by invasive medical procedures). * [[Pulmonary arterial hypertension]], elevated pressure in the pulmonary arteries. Most commonly it is [[idiopathic]] (i.e. of unknown cause) but it can be due to the effects of another disease, particularly COPD. This can lead to strain on the right side of the heart, a condition known as [[cor pulmonale]]. * [[Pulmonary edema]], leakage of fluid from capillaries of the lung into the [[Pulmonary alveolus|alveoli]] (or air spaces). It is usually due to congestive heart failure. * Pulmonary hemorrhage, inflammation and damage to capillaries in the lung resulting in blood leaking into the alveoli. This may cause blood to be coughed up. Pulmonary hemorrhage can be due to auto-immune disorders such as [[granulomatosis with polyangiitis]] and [[Goodpasture's syndrome]]. ==Neonatal diseases== Pulmonary diseases may also impact newborns, such as [[pulmonary hyperplasia]], [[pulmonary interstitial emphysema]] (usually [[preterm birth]]s), and [[infant respiratory distress syndrome]]. ==Diagnosis==<!-- PLEASE RESPECT ALPHABETICAL ORDER --> Respiratory diseases may be investigated by performing one or more of the following tests * [[Biopsy]] of the lung or pleura * [[Blood test]] * [[Bronchoscopy]] * [[Chest X-ray]] * [[CT scan]], including [[high-resolution computed tomography]] * [[Microbiological culture|Culture of microorganisms]] from secretions such as sputum * [[Medical ultrasonography|Ultrasound]] scanning can be useful to detect fluid such as [[pleural effusion]] * [[Pulmonary function test]] * [[Ventilation/perfusion scan|Ventilation–perfusion scan]] ==Epidemiology== [[File:Respiratory diseases world map-Deaths per million persons-WHO2012.svg|thumb|upright=1.3|Deaths from respiratory diseases per million persons in 2012 {{refbegin|3}}{{legend|#ffff20|19–125}}{{legend|#ffe820|126–169}}{{legend|#ffd820|170–196}}{{legend|#ffc020|197–225}}{{legend|#ffa020|226-–75}}{{legend|#ff9a20|276–308}}{{legend|#f08015|309–365}}{{legend|#e06815|366–440}}{{legend|#d85010|441–593}}{{legend|#d02010|594–1,227}}{{refend}}]] Respiratory disease is a common and significant cause of illness and death around the world. In the US, approximately one billion [[common colds]] occur each year.<ref>{{cite web | url=http://www3.niaid.nih.gov/topics/commonCold/ | title=National Institutes of Health – common cold | access-date=2008-05-07 | url-status=dead | archive-url=https://web.archive.org/web/20081001232444/http://www3.niaid.nih.gov/topics/commonCold/ | archive-date=2008-10-01 }}</ref> A study found that in 2010, there were approximately 6.8 million emergency department visits for respiratory disorders in the U.S. for patients under the age of 18.<ref>{{cite journal | vauthors = Wier LM, Yu H, Owens PL, Washington R | title = Overview of Children in the Emergency Department, 2010 | date = May 2013 | pmid = 24006551 | url = http://hcup-us.ahrq.gov/reports/statbriefs/sb157.jsp | journal = HCUP Statistical Brief #157. Agency for Healthcare Research and Quality }}</ref> In 2012, respiratory conditions were the most frequent reasons for hospital stays among children.<ref>{{cite web |vauthors=Witt WP, Wiess AJ, Elixhauser A | title = Overview of Hospital Stays for Children in the United States, 2012 | work = HCUP Statistical Brief #186 | publisher = Agency for Healthcare Research and Quality | location = Rockville, MD | date = December 2014 | url =https://www.hcup-us.ahrq.gov/reports/statbriefs/sb187-Hospital-Stays-Children-2012.jsp}}</ref> In the UK, approximately 1 in 7 individuals are affected by some form of chronic lung disease, most commonly [[chronic obstructive pulmonary disease]], which includes [[asthma]], [[Bronchitis#Chronic bronchitis|chronic bronchitis]] and [[emphysema]].<ref name="BLF">{{cite web |title=What is COPD? |url=https://www.blf.org.uk/support-for-you/copd/what-is-copd |website=British Lung Foundation |language=en |date=7 September 2015}}</ref> Respiratory diseases (including lung cancer) are responsible for over 10% of hospitalizations and over 16% of deaths in Canada.<ref name="PHAC">{{cite web|url=http://www.phac-aspc.gc.ca/ccdpc-cpcmc/crd-mrc/facts_gen_e.html|title=Public Health Agency of Canada – Centre for Chronic Disease Prevention and Control Chronic Respiratory Diseases|access-date=2008-05-06|url-status=dead|archive-url=https://web.archive.org/web/20080411135626/http://www.phac-aspc.gc.ca/ccdpc-cpcmc/crd-mrc/facts_gen_e.html|archive-date=2008-04-11}}</ref> In 2011, respiratory disease with ventilator support accounted for 93.3% of ICU utilization in the United States.<ref>{{cite web |vauthors=Barrett ML, Smith MW, Elizhauser A, Honigman LS, Pines JM | title = Utilization of Intensive Care Services, 2011 | work = HCUP Statistical Brief #185 | publisher = Agency for Healthcare Research and Quality | location = Rockville, MD | date = December 2014 | url =https://www.hcup-us.ahrq.gov/reports/statbriefs/sb185-Hospital-Intensive-Care-Units-2011.jsp}}</ref> {{clear}} == References == {{Reflist}} == External links == {{commons category|Diseases and disorders of the respiratory system}} {{Medical resources | DiseasesDB = | ICD10 = {{ICD10|J|00||j|00}}-{{ICD10|J|99||j|95}} | ICD9 = {{ICD9|460}}-{{ICD9|519}} | OMIM = | MedlinePlus = | GeneReviewsName = | ICDO = | eMedicineSubj = | eMedicineTopic = | MeshID = D012140 }} {{Respiratory pathology}} {{Certain conditions originating in the perinatal period}} {{Respiratory physiology}} {{Authority control}} {{DEFAULTSORT:Respiratory Disease}} [[Category:Respiratory diseases| ]]'