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The changes in airways structure associated with reduced forced expiratory volume in one second
K Matsuba1, J L Wright, B R Wiggs
1Research Institute for Diseases of the Chest, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
The European Respiratory Journal
|October 1, 1989
Summary
Airway obstruction in chronic obstructive pulmonary disease may involve more small membranous bronchioles and thickened respiratory bronchioles. These structural changes contribute to reduced airflow, impacting lung function.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
- Pathology
Background:
- Airway remodeling is a key feature of chronic obstructive pulmonary disease (COPD).
- Understanding structural changes in small airways is crucial for elucidating COPD pathogenesis.
Purpose of the Study:
- To compare the microstructural characteristics of membranous and respiratory bronchioles in patients with and without airflow obstruction.
- To investigate the relationship between airway wall thickness, lumen diameter, and reduced forced expiratory volume in one second (FEV1).
Main Methods:
- Histopathological analysis of resected lung tissue from 111 normal FEV1 and 45 reduced FEV1 patients.
- Quantification of membranous and respiratory bronchioles (<2 mm internal diameter).
- Measurement of airway diameter and wall thickness, calculating wall thickness to lumen diameter ratio.
Main Results:
- Patients with reduced FEV1 exhibited a higher number of small membranous bronchioles (<0.4 mm).
- Respiratory bronchioles showed increased wall thickness and a higher wall thickness to lumen diameter ratio in the obstructed group.
- Membranous bronchioles did not show increased wall thickness but had an increased wall thickness to lumen diameter ratio.
Conclusions:
- Findings support the hypothesis that airway wall thickening and lumen narrowing contribute to airflow obstruction in COPD.
- Airway distortion due to loss of elastic recoil cannot be excluded as a contributing factor.