{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T14:19:13Z","timestamp":1773757153095,"version":"3.50.1"},"reference-count":44,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[1989,1,1]],"date-time":"1989-01-01T00:00:00Z","timestamp":599616000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[1989,1,1]],"date-time":"1989-01-01T00:00:00Z","timestamp":599616000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journal.chestnet.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Chest"],"published-print":{"date-parts":[[1989,1]]},"DOI":"10.1378\/chest.95.1.190","type":"journal-article","created":{"date-parts":[[2007,11,7]],"date-time":"2007-11-07T13:25:26Z","timestamp":1194441926000},"page":"190-195","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":49,"title":["Pathogenesis of Emphysema"],"prefix":"10.1016","volume":"95","author":[{"given":"Mark","family":"Wewers","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1378\/chest.95.1.190_bib1","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1073\/pnas.79.6.2041","article-title":"Potential mechanism of emphysema: alpha1-proteinase inhibitor recovered from lungs of cigarette smokers contains oxidized methionine and has decreased elastase inhibitory capacity","volume":"79","author":"Carp","year":"1982","journal-title":"Proc Natl Acad Sci USA"},{"key":"10.1378\/chest.95.1.190_bib2","doi-asserted-by":"crossref","unstructured":"Damiano W, Tsang A, Kucich U, Abrams WR, Rosenbloom J, Kimbel P, Fallahnejad M, Weinbaum G. Immunolocalization of elastase in human emphysematous lungs. J Clin Invest 78:482\u201393","DOI":"10.1172\/JCI112600"},{"key":"10.1378\/chest.95.1.190_bib3","doi-asserted-by":"crossref","first-page":"680","DOI":"10.7326\/0003-4819-107-5-680","article-title":"Increased neutrophil elastase activity in cigarette smokers","volume":"107","author":"Weitz","year":"1987","journal-title":"Ann Intern Med"},{"key":"10.1378\/chest.95.1.190_bib4","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1161\/01.RES.16.4.353","article-title":"Permeability of the alveolar membrane to solutes","volume":"16","author":"Taylor","year":"1965","journal-title":"Circ Res"},{"key":"10.1378\/chest.95.1.190_bib5","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3109\/00365517109095696","article-title":"Neutral leucocyte proteases and elastase inhibited by plasma alpha1-antitrypsin","volume":"28","author":"Ohlsson","year":"1971","journal-title":"Scand J Clin Lab Invest"},{"key":"10.1378\/chest.95.1.190_bib6","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/0009-8981(77)90145-0","article-title":"The contribution of alpha1-antitrypsin to the total antitrypsin activity of human serum: a study of two phenotype Pi 00 individuals","volume":"80","author":"Kahn","year":"1977","journal-title":"Clin Chim Acta"},{"key":"10.1378\/chest.95.1.190_bib7","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1515\/bchm2.1984.365.1.587","article-title":"Low molecular mass bronchial proteinase inhibitor and alpha1-proteinase inhibitor in sputum and bronchoalveolar lavage","volume":"365","author":"Stockley","year":"1984","journal-title":"Hoppe-Seylers Z. Physiol Chem"},{"key":"10.1378\/chest.95.1.190_bib8","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1042\/bj2250463","article-title":"Human bronchial leucocyte proteinase inhibitor: rapid isolation and kinetic analysis with human leucocyte proteinases","volume":"225","author":"Smith","year":"1985","journal-title":"Biochem J"},{"key":"10.1378\/chest.95.1.190_bib9","first-page":"178","article-title":"Kinetics of the inhibition of leukocyte elastase by the bronchial inhibitor","volume":"700","author":"Gauthier","year":"1982","journal-title":"Bioch Biophys Acta"},{"key":"10.1378\/chest.95.1.190_bib10","first-page":"539","article-title":"Comparison of alpha1-antitrypsin levels and antineutrophil elastase capacity of blood and lung in a patient with the alpha1-antitrypsin phenotype Null-Null before and during alpha1-antitrypsin augmentation therapy","volume":"135","author":"Wewers","year":"1987","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.95.1.190_bib11","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1172\/JCI110344","article-title":"Antielastases of the human alveolar structures: implications for the protease-antiprotease theory of emphysema","volume":"68","author":"Gadek","year":"1981","journal-title":"J Clin Invest"},{"key":"10.1378\/chest.95.1.190_bib12","first-page":"5","article-title":"Studies in alpha1-antitrypsin deficiency","volume":"432","author":"Eriksson","year":"1965","journal-title":"Acta Med Scand"},{"key":"10.1378\/chest.95.1.190_bib13","first-page":"176","article-title":"Alpha1-antitrypsin and its deficiency","volume":"110","author":"Kueppers","year":"1974","journal-title":"Am Rev Resp Dis"},{"key":"10.1378\/chest.95.1.190_bib14","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/j.0954-6820.1978.tb08452.x","article-title":"Natural history and life expectancy in severe alpha1-antitrypsin deficiency, PiZ","volume":"204","author":"Larsson","year":"1978","journal-title":"Acta Med Scand"},{"key":"10.1378\/chest.95.1.190_bib15","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1080\/00365516309051324","article-title":"The electrophoretic alpha1-globulin pattern of serum in alpha1-antitrypsin deficiency","volume":"15","author":"Laurell","year":"1963","journal-title":"Scand J Clin Lab Invest"},{"key":"10.1378\/chest.95.1.190_bib16","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1172\/JCI110360","article-title":"Replacement therapy of alpha1-antitrypsin deficiency: reversal of protease-antiprotease imbalance within the alveolar structures of PiZ subjects","volume":"68","author":"Gadek","year":"1981","journal-title":"J Clin Invest"},{"key":"10.1378\/chest.95.1.190_bib17","first-page":"632","article-title":"Smoking and leucocyte counts: results of an epidemiological study","volume":"2","author":"Cone","year":"1971","journal-title":"Lancet"},{"key":"10.1378\/chest.95.1.190_bib18","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1172\/JCI110480","article-title":"Studies on the pathogenesis of the adult respiratory distress syndrome","volume":"69","author":"McGuire","year":"1982","journal-title":"J Clin Invest"},{"key":"10.1378\/chest.95.1.190_bib19","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1056\/NEJM198101223040402","article-title":"Elastolytic activity in pulmonary lavage fluid from patients with adult respiratory-distress syndrome","volume":"304","author":"Lee","year":"1981","journal-title":"N Engl J Med"},{"key":"10.1378\/chest.95.1.190_bib20","first-page":"218","article-title":"Lung neutrophils in the adult respiratory distress syndrome: clinical and pathophysiologic significance","volume":"133","author":"Weiland","year":"1986","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.95.1.190_bib21","first-page":"1098","article-title":"Neutrophil elastase-releasing factors in bronchoalveolar lavage from patients with adult respiratory distress syndrome","volume":"132","author":"Idell","year":"1985","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.95.1.190_bib22","doi-asserted-by":"crossref","first-page":"50S","DOI":"10.1378\/chest.81.5_Supplement.50S","article-title":"Characterization of antiproteinase activity in the adult respiratory distress syndrome","volume":"81","author":"Fowler","year":"1982","journal-title":"Chest"},{"key":"10.1378\/chest.95.1.190_bib23","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1172\/JCI110823","article-title":"Pathogenesis of the adult respiratory distress syndrome: evidence of oxidant activity in bronchoalveolar lavage fluid","volume":"71","author":"Cochrane","year":"1983","journal-title":"J Clin Invest"},{"key":"10.1378\/chest.95.1.190_bib24","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1172\/JCI112743","article-title":"Protein permeability in the adult respiratory distress syndrome: loss of size selectivity of the alveolar epithelium","volume":"78","author":"Holter","year":"1986","journal-title":"J Clin Invest"},{"key":"10.1378\/chest.95.1.190_bib25","unstructured":"Wewers MD, Herzyk DJ, Gadek JE. Alveolar fluid neutrophil elastase activity in the adult respiratory distress syndrome is complexed to alpha-2-macroglobulin. J Clin Invest (in press)"},{"key":"10.1378\/chest.95.1.190_bib26","series-title":"The metabolic basis of inherited disease","first-page":"1889","article-title":"Cystic fibrosis","author":"Talamo","year":"1983"},{"key":"10.1378\/chest.95.1.190_bib27","first-page":"207A","article-title":"A role for neutrophils in the derangements of the bronchial wall characteristic of cystic fibrosis","volume":"127","author":"Davis","year":"1983","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.95.1.190_bib28","first-page":"151","article-title":"Pseudomonas respiratory infection in cystic fibrosis: a possible defect in opsonic IgG antibody","volume":"19","author":"Fick","year":"1983","journal-title":"Bull Eur Physiopathol Respir"},{"key":"10.1378\/chest.95.1.190_bib29","first-page":"529","article-title":"Biochemical and pathological evidence for proteolytic destruction of lung connective tissue in cystic fibrosis","volume":"132","author":"Bruce","year":"1985","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.95.1.190_bib30","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1164\/arrd.1984.129.5.735","article-title":"Proteinase inhibitory function in inflammatory lung disease: acute bacterial pneumonia","volume":"129","author":"Abrams","year":"1984","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.95.1.190_bib31","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1164\/arrd.1983.127.5.540","article-title":"Levels of elastase activity in bronchoalveolar lavage fluids of healthy smokers and nonsmokers","volume":"127","author":"Janoff","year":"1983","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.95.1.190_bib32","first-page":"568","article-title":"Acute effect of smoking on elastaselike esterase activity and immunological neutrophil elastase levels in bronchoalveolar lavage fluid","volume":"133","author":"Fera","year":"1986","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.95.1.190_bib33","first-page":"833","article-title":"Cigarette smoking and lung destruction: accumulation of neutrophils in the lungs of cigarette smokers","volume":"128","author":"Hunninghake","year":"1983","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.95.1.190_bib34","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1126\/science.316188","article-title":"Cigarette smoking induces functional antiprotease deficiency in the lower respiratory tract of humans","volume":"206","author":"Gadek","year":"1979","journal-title":"Science"},{"key":"10.1378\/chest.95.1.190_bib35","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1126\/science.6612333","article-title":"Functional alpha1-protease inhibitor in the lower respiratory tract of cigarette smokers is not decreased","volume":"221","author":"Stone","year":"1983","journal-title":"Science"},{"key":"10.1378\/chest.95.1.190_bib36","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/0009-8981(83)90009-8","article-title":"The functional activity of alpha1-proteinase inhibitor in bronchoalveolar lavage fluids from healthy human smokers and non-smokers","volume":"132","author":"Boudie","year":"1983","journal-title":"Clin Chim Acta"},{"key":"10.1378\/chest.95.1.190_bib37","first-page":"79","article-title":"Acute effect of smoking on the functional activity of alpha1-protease inhibitor in bronchoalveolar lavage fluid","volume":"131","author":"Abboud","year":"1985","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.95.1.190_bib38","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1042\/cs0690017","article-title":"Extracellular elastolytic activity in human lung lavage: a comparative study between smokers and non-smokers","volume":"69","author":"Smith","year":"1985","journal-title":"Clin Sci"},{"key":"10.1378\/chest.95.1.190_bib39","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1172\/JCI110681","article-title":"Proteolysis by neutrophils: relative importance of cell-substrate contact and oxidative inactivation of proteinase inhibitors in vitro.","volume":"70","author":"Campbell","year":"1982","journal-title":"J Clin Invest"},{"key":"10.1378\/chest.95.1.190_bib40","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1172\/JCI111586","article-title":"Comparison of live human neutrophil and alveolar macrophage elastolytic activity in vitro: relative resistance of macrophage elastolytic activity to serum and alveolar proteinase inhibitors","volume":"74","author":"Chapman","year":"1984","journal-title":"J Clin Invest"},{"key":"10.1378\/chest.95.1.190_bib41","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1084\/jem.152.6.1537","article-title":"Degradation of connective tissue matrices by macrophages. III. Morphological and biochemical studies on extracellular, pericellular, and intracellular events in matrix proteolysis by macrophages in culture","volume":"152","author":"Werb","year":"1980","journal-title":"J Exper Med"},{"key":"10.1378\/chest.95.1.190_bib42","first-page":"A291","article-title":"Alpha1-antitrypsin in the lower respiratory tract of cigarette smokers has a decreased association rate constant for neutrophil elastase","volume":"135","author":"Fells","year":"1987","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.95.1.190_bib43","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1056\/NEJM197410102911503","article-title":"Pathologic changes in the peripheral airways of young cigarette smokers","volume":"291","author":"Niewoehner","year":"1974","journal-title":"N Engl J Med"},{"key":"10.1378\/chest.95.1.190_bib44","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1172\/JCI113204","article-title":"Oxidants spontaneously released by alveolar macrophages of cigarette smokers can inactivate the active site of alpha1-antitrypsin, rendering it ineffective as an inhibitor of neutrophil elastase","volume":"80","author":"Hubbard","year":"1987","journal-title":"J Clin Invest"}],"container-title":["Chest"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0012369216336157?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0012369216336157?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T07:39:08Z","timestamp":1757921948000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0012369216336157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1989,1]]},"references-count":44,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1989,1]]}},"alternative-id":["S0012369216336157"],"URL":"https:\/\/doi.org\/10.1378\/chest.95.1.190","relation":{},"ISSN":["0012-3692"],"issn-type":[{"value":"0012-3692","type":"print"}],"subject":[],"published":{"date-parts":[[1989,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Pathogenesis of Emphysema","name":"articletitle","label":"Article Title"},{"value":"Chest","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1378\/chest.95.1.190","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 1989 The American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}