Every time you breathe in, air travels down the trachea, through a series of channels called bronchi, and finally reaches little clusters of air sacs called alveoli. There are some 600 million alveoli in the lungs, adding up to a surface area of roughly 75 square meters— the size of a tennis court. These tiny sacs, only one cell thick, facilitate a crucial exchange: allowing oxygen from the air we breathe into the bloodstream and clearing out carbon dioxide.
Svaki put kada udahnete, vazduh putuje niz dušnik, kroz niz kanala koji se nazvaju bronhije, i konačno stiže do malih grupa vazdušnih kesa koje se nazivaju alveole. Postoji oko 600 miliona alveola u plućima, što čini površinu od otprilike 75 kvadratnih metara— to je veličina jednog teniskog terena. Ove sićušne kese, debljine jedne ćelije, omogućavaju bitnu razmenu: sprovode kiseonik iz vazduha koji dišemo u krvotok i izbacuju ugljen-dioksid.
Pneumonia wreaks havoc on this exchange. Pneumonia is an infection of the alveoli that causes them to fill with fluid. There are many different kinds of pathogens that can cause pneumonia. The most common ones are viruses or bacteria.
Pneumonija izaziva haos u ovoj razmeni. Pneumonija je infekcija alveola koja čini da se one napune tečnošću. Postoji mnogo različitih patogena koji mogu da izazovu pneumoniju. Najčešći su virusi i bakterije.
These microscopic invaders enter the body via droplets either in the air we breathe, or when we touch our eyes, noses, or mouths after touching a contaminated surface. Then, they face the respiratory tract’s first line defense: the mucociliary escalator. The mucociliary escalator consists of mucus that traps invaders and tiny hairs called cilia that carry the mucus toward the mouth, where it can be coughed out.
Ovi sićušni napadači ulaze u telo preko kapljica iz vazduha, ili kad dodirujemo oči, nos ili usta nakon pipanja kontaminirane površine. Zatim se suočavaju sa prvom linijom odbrane respiratornog trakta: mukocilijarnim eskalatorom. Mukocilijarni eskalator se sastoji od sluzi koja hvata napadače i dlačica koje se zovu cilije koje nose sluz ka ustima, gde može da se iskašlje.
But some of these invaders may get past the mucociliary escalator into the lungs, where they meet the alveoli. Because alveoli serve as critical exchange points between the blood and air from the outside world, they have their own specialized types of white blood cells, or macrophages, which defend against foreign organisms by enveloping and eating them. When pathogens enter the lungs, the macrophages work to destroy them. The immune system releases additional white blood cells in the alveoli to help. As these immune cells fight the pathogens, they generate inflammation— and fluid as a by-product of the inflammation.
Ali neki od ovih napadača mogu da prođu kroz mukocilijarni eskalator u pluća, gde sreću alveole. Zbog toga što su alveole kritične tačke razmene između krvi i vazduha iz spoljnog sveta, one imaju svoje specijalizovane tipove belih krvnih zrnaca ili makrofaga, koje se brane od stranih organizama tako što ih obaviju i pojedu. Kada patogeni uđu u pluća, makrofage rade na njihovom uništenju. Imuni sistem oslobađa dodatna bela krvna zrnca u alveolama za pomoć. Kako imune ćelije napadaju patogene, one izazivaju upalu— i tečnost kao nusprodukt upale.
When this fluid builds up, it makes gas exchange inside the alveoli much more difficult. As the level of carbon dioxide in the bloodstream begins to rise, the body breathes more quickly to try to clear it out and get more oxygen in. This rapid breathing is one of the most common symptoms of pneumonia. The body also tries to force the fluid out of the alveoli through coughing.
Kada dođe do gomilanja tečnosti, razmena gasova unutar alveola postaje otežana. Kako nivo ugljen-dioksida u krvi počinje da raste, telo diše brže kako bi ga izbacilo i unelo više kiseonika. Ubrzano disanje je jedan od najčešćih simptoma pneumonije. Takođe, telo pokušava da izbaci tečnost iz alveola kroz kašalj.
Determining the cause of pneumonia can be difficult, but once it is established, doctors can prescribe antibiotics, which may include either antibacterial or antiviral treatments. Treatment with antibiotics helps the body get the infection under control. As the pathogen is cleared out, the body gradually expels or absorbs fluid and dead cells. The worst symptoms typically fade out in about a week, though full recovery may take as long as a month.
Utvrđivanje uzroka pneumonije može biti teško, ali kad se jednom utvrdi, lekari mogu da prepišu antibiotike, koji mogu uključivati antibakterijske ili antivirusne terapije. Terapija antibioticima pomaže telu da drži infekciju pod kontrolom. Kada se patogen raščisti, telo postepeno izbacuje ili apsorbuje tečnost i mrtve ćelije. Najteži simptomi najčešće iščeznu za otprilike nedelju dana, dok potpuni oporavak može da traje i mesec dana.
Otherwise healthy adults can often manage pneumonia at home. But for some groups, pneumonia can be a lot more severe, requiring hospitalization and oxygen, artificial ventilation, or other supportive measures while the body fights the infection. Smoking damages the cilia, making them less able to clear even the normal amount of mucus and secretions, let alone the increased volume associated with pneumonia. Genetic and autoimmune disorders can make someone more susceptible to pathogens that can cause pneumonia. Young children and the elderly also have impaired clearance and weaker immune systems. And if someone has viral pneumonia, their risk of bacterial respiratory infection is higher.
Inače zdrave odrasle osobe mogu da leče pneumoniju kod kuće. Ali za neke grupe ljudi, pneumonija može biti mnogo teža, može da zahteva hospitalizaciju i kiseonik, mehaničku ventilaciju, i ostale mere podrške dok se telo bori protiv infekcije. Pušenje oštećuje cilije, čineći ih manje sposobnim da očiste čak i normalne količine sluzi i sekreta, a kamoli obimne količine povezane sa pneumonijom. Genetski i autoimuni poremećaji mogu učiniti nekog podložnijim patogenima koji uzrokuju pneumoniju. Mala deca i starije osobe takođe imaju narušen klirens i slabiji imuni sistem. A, ako neko ima virusnu pneumoniju, njihov rizik od bakterijske respiratorne infekcije je visok.
Many of the deaths from pneumonia are due to lack of access to healthcare. But sometimes, even with appropriate care, the body enters a sustained fight against the infection it can’t maintain, activating inflammatory pathways throughout the body, not just in the lungs. This is actually a protective mechanism, but after too long in this state organs start shutting down, causing shock and sometimes death.
Mnogi smrtni slučajevi od pneumonije su zbog nedostatka zdravstvene zaštite. Ali ponekad, čak i uz adekvatnu negu, telo ulazi u neprekidnu borbu protiv infekcije koju ne može da obuzda, tako što aktivira upalne puteve u celom telu, ne samo u plućima. Ovo je u stvari zaštitni mehanizam, ali nakon predugo vremena u ovom stanju organi počinju da se gase, uzrokujući šok, a ponekad i smrt.
So how can we prevent pneumonia? Eating well and getting enough sleep and exercise helps your body fight off infections. Vaccines can protect against common pneumonia-causing pathogens, while washing your hands regularly helps prevent the spread of these pathogens— and protect those most vulnerable to severe pneumonia.
Kako onda možemo sprečiti pneumoniju? Dobra ishrana, dovoljno sna i vežbanje pomažu telu da se bori protiv infekcija. Vakcine mogu da nas zaštite od uobičajenih patogena kod pneumonije, dok redovno pranje ruku pomaže u sprečavanju širenja ovih patogena— i štiti one koji su najpodložniji teškoj pneumoniji.