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Small Airway Disease in Pre-Chronic Obstructive Pulmonary Disease with Emphysema: A Cross-Sectional Study.
Verleden, Stijn E; Hendriks, Jeroen M H; Snoeckx, Annemiek; Mai, Cindy; Mentens, Yves; Callebaut, Wim; De Belie, Bruno; Van Schil, Paul E; Verplancke, Veronique; Janssens, Annelies; Jacob, Joseph; Pakzad, Ashkan; Conlon, Thomas M; Guvenc, Guney; Yildirim, Ali Önder; Pauwels, Patrick; Koljenovic, Senada; Kwakkel-Van Erp, Johanna M; Lapperre, Thérèse S.
Afiliación
  • Verleden SE; Division of Thoracic Surgery, Antwerp Surgical Training, Anatomy and Research Centre.
  • Hendriks JMH; Department of Thoracic and Vascular Surgery.
  • Snoeckx A; Department of Pulmonology.
  • Mai C; Division of Thoracic Surgery, Antwerp Surgical Training, Anatomy and Research Centre.
  • Mentens Y; Department of Thoracic and Vascular Surgery.
  • Callebaut W; Department of Molecular Morphology Microscopy, Faculty of Medicine and Health Sciences.
  • De Belie B; Department of Radiology.
  • Van Schil PE; Department of Radiology.
  • Verplancke V; Department of Pulmonology, General Hospital Herentals, Herentals, Belgium.
  • Janssens A; Department of Pulmonology, General Hospital Voorkempen, Malle, Belgium.
  • Jacob J; Department of Pulmonology, General Hospital, Rumst, Belgium.
  • Pakzad A; Division of Thoracic Surgery, Antwerp Surgical Training, Anatomy and Research Centre.
  • Conlon TM; Department of Thoracic and Vascular Surgery.
  • Guvenc G; Department of Pulmonology.
  • Yildirim AÖ; Department of Thoracic Oncology, and.
  • Pauwels P; Department of Radiology, University College London Hospitals National Health Service Foundation Trust, London, United Kingdom.
  • Koljenovic S; Department of Radiology, University College London Hospitals National Health Service Foundation Trust, London, United Kingdom.
  • Kwakkel-Van Erp JM; Comprehensive Pneumology Center, Institute of Lung Health and Immunity, Helmholtz Munich, Munich, Germany; and.
  • Lapperre TS; Comprehensive Pneumology Center, Institute of Lung Health and Immunity, Helmholtz Munich, Munich, Germany; and.
Am J Respir Crit Care Med ; 209(6): 683-692, 2024 Mar 15.
Article en En | MEDLINE | ID: mdl-38055196
Rationale: Small airway disease is an important pathophysiological feature of chronic obstructive pulmonary disease (COPD). Recently, "pre-COPD" has been put forward as a potential precursor stage of COPD that is defined by abnormal spirometry findings or significant emphysema on computed tomography (CT) in the absence of airflow obstruction. Objective: To determine the degree and nature of (small) airway disease in pre-COPD using microCT in a cohort of explant lobes/lungs. Methods: We collected whole lungs/lung lobes from patients with emphysematous pre-COPD (n = 10); Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I (n = 6), II (n = 6), and III/IV (n = 7) COPD; and controls (n = 10), which were analyzed using CT and microCT. The degree of emphysema and the number and morphology of small airways were compared between groups, and further correlations were investigated with physiologic measures. Airway and parenchymal pathology was also validated with histopathology. Measurements and Main Results: The numbers of transitional bronchioles and terminal bronchioles per milliliter of lung were significantly lower in pre-COPD and GOLD stages I, II, and III/IV COPD compared with controls. In addition, the number of alveolar attachments of the transitional bronchioles and terminal bronchioles was also lower in pre-COPD and all COPD groups compared with controls. We did not find any differences between the pre-COPD and COPD groups in CT or microCT measures. The percentage of emphysema on CT showed the strongest correlation with the number of small airways in the COPD groups. Histopathology showed an increase in the mean chord length and a decrease in alveolar surface density in pre-COPD and all GOLD COPD stages compared with controls. Conclusions: Lungs of patients with emphysematous pre-COPD already show fewer small airways and airway remodeling even in the absence of physiologic airway obstruction.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfisema Pulmonar / Asma / Enfermedad Pulmonar Obstructiva Crónica / Enfisema Límite: Humans Idioma: En Revista: Am J Respir Crit Care Med Asunto de la revista: TERAPIA INTENSIVA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfisema Pulmonar / Asma / Enfermedad Pulmonar Obstructiva Crónica / Enfisema Límite: Humans Idioma: En Revista: Am J Respir Crit Care Med Asunto de la revista: TERAPIA INTENSIVA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos