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I'm studying COPD for my Pneumology exam and among my notes I've just read that panlobular emphysema in AAT deficiency is more severe at the lung apex as the blood flow is reduced (less AAT) and ventilation is maximal (more polluting agents).
In Robbins I can read exactly the opposite, i.e. in this case lesions are more severe at the bases. I obviously trust my textbook more than my notes but there is no explanation of the reasons of this and I can't think of many at the moment. May it be that at the bases there is less AAT but also more trypsin as there is more blood flow?
Can anybody give me a clue?
Thanks a lot!