|
Title
|
|
|
|
Analysis of airway pathology in COPD using a combination of computed tomography, micro-computed tomography and histology
| |
|
Author
|
|
|
|
| |
|
Abstract
|
|
|
|
| The small conducting airways are the major site of obstruction in chronic obstructive pulmonary disease (COPD). This study examined small airway pathology using a novel combination of multidetector row computed tomography (MDCT), micro-computed tomography (microCT) and histology. Airway branches visible on specimen MDCT were counted and the dimensions of the third- to fifth-generation airways were computed, while the terminal bronchioles (designated TB), preterminal bronchioles (TB-1) and pre-preterminal bronchioles (TB-2) were examined with microCT and histology in eight explanted lungs with end-stage COPD and seven unused donor lungs that served as controls. On MDCT, COPD lungs showed a decrease in the number of 2-2.5 mm diameter airways and the lumen area of fifth-generation airways, while on microCT there was a reduction in the number of terminal bronchioles as well as a decrease in the luminal areas, wall volumes and alveolar attachments to the walls of TB, TB-1 and TB-2 bronchioles. The combination of microCT and histology showed increased B-cell infiltration into the walls of TB-1 and TB-2 bronchioles, and this change was correlated with a reduced number of alveolar attachments in COPD. Small airways disease extends from 2 mm diameter airways to the terminal bronchioles in COPD. Destruction of alveolar attachments may be driven by a B-cell-mediated immune response in the preterminal bronchioles. |
| |
|
Language
|
|
|
|
English
| |
|
Source (journal)
|
|
|
|
The European respiratory journal / European Respiratory Society [Lausanne] - Copenhagen, 1988, currens
| |
|
Publication
|
|
|
|
Copenhagen
:
2018
| |
|
ISSN
|
|
|
|
0903-1936
[print]
1399-3003
[online]
| |
|
DOI
|
|
|
|
10.1183/13993003.01245-2017
| |
|
Volume/pages
|
|
|
|
51
:2
(2018)
, 10 p.
| |
|
Article Reference
|
|
|
|
1701245
| |
|
ISI
|
|
|
|
000429419700001
| |
|
Pubmed ID
|
|
|
|
29444912
| |
|
Medium
|
|
|
|
E-only publicatie
| |
|
Full text (Publisher's DOI)
|
|
|
|
| |
|