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The Protease Theory of Emphysema

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The Ohio State University Hospitals

Ann Intern Med. 1987;107(5):761-763. doi:10.7326/0003-4819-107-5-761
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The elegant study of Weitz and colleagues reported in this issue (1) comes as a timely reconciliation of the controversy in our efforts to understand the pathogenesis of emphysema. The work of these investigators reflects an experimental continuum that dates to the dawn of modern thought on pulmonary emphysema. Before 1962, clinicians and investigators speculated that the destruction of alveolar surfaces resulted from the barotrauma attendant to limitation of expiratory airflow. Although this hypothesis encompassed the scientific evidence available at the time, the perspectives gained during the last quarter century suggest that limitation of airflow is a consequence, rather than


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