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Updated: Aug 8, 2026

Murine Intrapulmonary Tracheal Transplantation: A Model for Investigating Obliterative Airway Disease After Lung Transplantation
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Murine Intrapulmonary Tracheal Transplantation: A Model for Investigating Obliterative Airway Disease After Lung Transplantation

Published on: November 10, 2023

Characterization of Airway Morphology in Post-infectious versus Post-lung Transplant Bronchiolitis Obliterans

Roel Martens1,2, Birgit Weynand1,2, Alexandra De Zutter3

  • 1Department of Translational Cell and Tissue Research, KU Leuven, Leuven, Belgium.

The European Respiratory Journal
|August 6, 2026
PubMed

Insights

Post-infectious bronchiolitis obliterans (PIBO) lungs show significantly fewer terminal bronchioles than bronchiolitis obliterans syndrome (BOS) lungs. Morphological differences in airway obstructions suggest dysanaptic lung growth in PIBO.

Area of Science:

  • Pulmonary Medicine
  • Pediatric Pulmonology
  • Thoracic Surgery

Background:

  • Post-infectious bronchiolitis obliterans (PIBO) can follow childhood infections.
  • Dysanaptic lung growth, characterized by differential alveolar and airway development, is a suspected but elusive consequence of PIBO.
  • This study investigates the airway morphology in PIBO compared to bronchiolitis obliterans syndrome (BOS).

Purpose of the Study:

  • To perform a detailed morphological characterization of the entire airway tree in PIBO.
  • To compare airway morphology in PIBO with that of bronchiolitis obliterans syndrome (BOS) and control lungs.
  • To identify structural evidence supporting the hypothesis of dysanaptic lung growth in PIBO.

Main Methods:

  • Ex vivo high-resolution computed tomography (CT) scans were used for 3D airway segmentation of lungs from PIBO, BOS, and control groups.
  • Micro-CT and histology were employed for 3D assessment of terminal bronchioles in lung tissue samples.
  • Quantitative analysis focused on airway number, diameter, obstruction, and terminal bronchiole characteristics.

Main Results:

  • Airway diameters were increased in both PIBO and BOS compared to controls, with no significant difference between PIBO and BOS.
  • PIBO lungs had significantly fewer terminal bronchioles (nearly threefold decrease) compared to BOS and controls.
  • Airway obstructions differed, being more numerous but smaller in BOS, and larger but less numerous in PIBO, with distinct patterns of pre-terminal bronchiole obstruction.

Conclusions:

  • PIBO lungs exhibit a substantial reduction in terminal bronchioles compared to BOS lungs.
  • Distinct morphological differences in airway obstruction type and location were observed between PIBO and BOS.
  • These findings provide structural evidence supporting dysanaptic lung growth as a consequence of PIBO.
Abstract

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