Heterogeneity of responsiveness of individual airways in cultured lung explants

Several lines of evidence suggest that the responsiveness of the airways is heterogeneous, although the magnitude of this heterogeneity has not been quantified. We have developed a videomicroscopic method that allows the measurements of the responsiveness of individual explanted airways to contractile agonists such as methacholine. Liquid agarose at 37 degrees C is injected into human lung segments to inflate them to a volume equivalent to total lung capacity. The agarose-filled lungs are then gelled by brief refrigeration and 0.5-mm-thick explants prepared by sectioning. The explants are cultured overnight under conventional conditions. Sections with airways cut in cross section are identified and placed on an inverted videomicroscope. Airway lumen area is then measured following administration of methacholine in increasing concentrations, permitting the construction of dose-response curves for each airway segment studied. This system thus lends itself to the study of the heterogeneity of airway responsiveness across the airway tree by permitting the study of distributions of airways. Using this approach, we have observed a very high degree of heterogeneity of responsiveness across the airways of human lungs. In this report, we review these findings and discuss the physiologic implications of heterogeneity.