The Pathology of Chronic Obstructive Pulmonary Disease

Client
Dr. Shelley Wall, Biomedical Communications, University of Toronto
Dr. John Wong, Laboratory Medicine & Pathology, University of Toronto

A two-page editorial depicting the complex and multifaceted causes and symptoms of chronic obstructive pulmonary disease (COPD).

Audience
General
Media
Adobe Photoshop
Adobe Illustrator
Date completed
December 2017
final COPD illustration
COPD is a difficult pathology to visualize since it occurs at multiple sites and scales. Furthermore, many factors interinfluence and contribute to the symptoms of the disease, so my biggest challenge was trying to understand that complex narrative, then translating that information in an easy-to-understand and clear way.
Research and preparatory studies

I researched extensively in order to understanding the major players in the disease and the progression of the disease. Afterwards, I did some preparatory studies (tissue cubes and landscape) to explore different ways to depict the environment and temporal aspect of the disease. I consulted histology slides and electron micrographs to accurately represent the pathology.

Composition Sketches

I decided to focus on concrete steps in the narrative and establishing a clear flow of information. I also wanted to integrate cross-sections in a landscape scene. Eventually, I settled on a composition that was inspired by the branching of trees to incorporate an organic yet editorial feel.

Colour studies and rendering

I wanted something high-key that would better convey the airy-ness of the tissue environment. I paid careful attention to tonal values to make sure crucial parts were more visually salient.

tissue lanscape
tissue lanscape
final COPD sketch
final COPD sketch
final COPD sketch
final COPD sketch
final COPD sketch
final COPD sketch
final COPD sketch
Works consulted

Baraldo, Simonetta, Graziella Turato, and Marina Saetta. 2012. “Pathophysiology of the Small Airways in Chronic Obstructive Pulmonary Disease.” Respiration 84 (2): 89–97. doi:10.1159/000341382.

Black, P. N., P. S.T. Ching, B. Beaumont, S. Ranasinghe, G. Taylor, and M. J. Merrilees. 2008. “Changes in Elastic Fibres in the Small Airways and Alveoli in COPD.” European Respiratory Journal 31 (5): 998–1004. doi:10.1183/09031936.00017207.

Brashier, Bill B, and Rahul Kodgule. 2012. “Risk Factors and Pathophysiology of Chronic Obstructive Pulmonary Disease (COPD).” The Journal of the Association of Physicians of India 60 Suppl (February): 17–21. doi:10.1124/pr.54.2.227.

Eeden, Stephan F van, and Don D Sin. 2013. “Oxidative Stress in Chronic Obstructive Pulmonary Disease: A Lung and Systemic Process.” Canadian Respiratory Journal : Journal of the Canadian Thoracic Society 20 (1): 27–29. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3628643&tool=pmcentrez&rendertype=abstract.

Gea, J., A. Agusti, and J. Roca. 2013. “Pathophysiology of Muscle Dysfunction in COPD.” Journal of Applied Physiology 114 (9): 1222–34. doi:10.1152/japplphysiol.00981.2012.

Hassan, Wafaa Ali, and Eman Abo-elhamd. 2014. “Emphysema versus Chronic Bronchitis in COPD : Clinical and Radiologic Characteristics,” no. June: 155–62.

Hostler, Jordanna, A. Whitney Brown, John Sherner, Christopher S. King, and Steven D. Nathan. 2013. “Pulmonary Hypertension in COPD.” European Respiratory Monograph 59 (5): 189–205. doi:10.1183/1025448x.10012412.

James, A. L., and S. Wenzel. 2007. “Clinical Relevance of Airway Remodelling in Airway Diseases.” European Respiratory Journal 30 (1): 134–55. doi:10.1183/09031936.00146905.

Kim, Victor, and Gerard J. Criner. 2013. “Chronic Bronchitis and Chronic Obstructive Pulmonary Disease.” American Journal of Respiratory and Critical Care Medicine 187 (3): 228–37. doi:10.1164/rccm.201210-1843CI.

Kirkham, Paul A., and Peter J. Barnes. 2013. “Oxidative Stress in COPD.” Chest 144 (1). The American College of Chest Physicians: 266–73. doi:10.1378/chest.12-2664.

MacNee, W. 2006. “ABC of Chronic Obstructive Pulmonary Disease: Pathology, Pathogenesis, and Pathophysiology.” BMJ: British Medical Journal 332 (7551): 1202. doi:10.1136/bmj.332.7551.1202.

Rodríguez-Roisin, Roberto. 2005. “The Airway Pathophysiology of COPD: Implications for Treatment.” COPD: Journal of Chronic Obstructive Pulmonary Disease 2 (2): 253–62. doi:10.1081/COPD-57598.

Rogers, Duncan F. 2005. “The Role of Airway Secretions in COPD: Pathophysiology, Epidemiology and Pharmacotherapeutic Options.” COPD: Journal of Chronic Obstructive Pulmonary Disease 2 (3): 341–53. doi:10.1080/15412550500218098.

Sakao, Seiichiro, Norbert F. Voelkel, and Koichiro Tatsumi. 2014. “The Vascular Bed in COPD: Pulmonary Hypertension and Pulmonary Vascular Alterations.” European Respiratory Review 23 (133): 350–55. doi:10.1183/09059180.00007913.

Sethi, Sanjay, Donald A. Mahler, Philip Marcus, Caroline A. Owen, Barbara Yawn, and Stephen Rennard. 2012. “Inflammation in COPD: Implications for Management.” American Journal of Medicine 125 (12). Elsevier Inc.: 1162–70. doi:10.1016/j.amjmed.2012.06.024.

Siddiqui, Salman, and Omar S Usmani. 2012. “Small Airways, Big Challenge: Measuring the Unseen?” Nature Medicine 18 (11). Nature Publishing Group: 1619–21. doi:10.1038/nm.2981.