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Automated Measurement of Pulmonary Emphysema and Small Airway Remodeling in Cigarette Smoke-exposed Mice
Published on: January 16, 2015
Small airway pathology and bronchoreversibility in advanced emphysema
Victor Kim1, Rita M Pechulis, Mohammad Abuel-Haija
1Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, United States. victor.kim@tuhs.temple.edu
COPD
|April 20, 2010
Summary
In severe emphysema, increased small airway smooth muscle mass may influence bronchodilator reversibility (BDR). This finding helps understand COPD heterogeneity and potential treatment targets.
Area of Science:
- Pulmonary Medicine
- Respiratory Pathology
- Surgical Research
Background:
- Chronic obstructive pulmonary disease (COPD) is characterized by poorly reversible airflow obstruction.
- Significant bronchodilator reversibility (BDR) occurs in some COPD patients, but the underlying pathology is unknown.
Purpose of the Study:
- To investigate the small airway pathologic features associated with bronchodilator reversibility in patients with severe emphysema.
Main Methods:
- Sixty-seven patients with upper lobe predominant emphysema undergoing lung volume reduction surgery were divided into reversible (BD(+)) and irreversible (BD(-)) groups based on FEV1/FVC response to bronchodilators.
- Histomorphometric analysis of small airways (<2 mm internal diameter) was performed on resected lung tissue, measuring epithelial height, epithelium area, subepithelium, smooth muscle, and total wall, adjusted for basement membrane area/perimeter.
Main Results:
- The reversible group (BD(+)) exhibited smaller epithelial height and epithelial height/perimeter, and greater smooth muscle wall area/basement membrane area compared to the irreversible group (BD(-)).
- Epithelium area trended smaller in the BD(+) group. In a subset with consistent BDR, the BD(+) group showed greater smooth muscle wall area/basement membrane area and total wall area/basement membrane area.
Conclusions:
- Increased small airway smooth muscle mass may be a key factor in determining bronchodilator reversibility in severe emphysema patients.
- These findings contribute to understanding COPD heterogeneity and potential therapeutic targets for improving airflow obstruction reversibility.
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