TY - JOUR
T1 - Airway inflammation in severe chronic obstructive pulmonary disease
T2 - Relationship with lung function and radiologic emphysema
AU - Turato, Graziella
AU - Zuin, Renzo
AU - Miniati, Massimo
AU - Baraldo, Simonetta
AU - Rea, Federico
AU - Beghé, Bianca
AU - Monti, Simonetta
AU - Formichi, Bruno
AU - Boschetto, Piera
AU - Harari, Sergio
AU - Papi, Alberto
AU - Maestrelli, Piero
AU - Fabbri, Leonardo M.
AU - Saetta, Marina
PY - 2002/7/1
Y1 - 2002/7/1
N2 - The lung pathology of severe chronic obstructive pulmonary disease (COPD) has been poorly investigated. We examined surgical specimens obtained from patients with severe (forced expiratory volume in 1 second [FEV 1] = 29 ± 3% predicted, n = 9) or mild/no airflow limitation (FEV 1 = 86 ± 5% predicted, n = 9) and similar smoking history. With histochemical and immunohistochemical methods we quantified the structural changes and the inflammatory cells in small airways and in muscular pulmonary arteries. As compared with smokers with mild/no COPD, smokers with severe COPD had an increased number of leukocytes in the small airways, which showed a positive correlation with the radiologic score of emphysema and with the value of residual volume, and a negative correlation with the values of FEV 1 and carbon monoxide diffusing capacity. The inflammatory process was characterized by an increase in CD8 + and CD4 + T-lymphocytes in the airway wall and by an increase in macrophages in the airway epithelium. When all smokers were considered together, the smoking history was correlated with both the airway wall and smooth muscle thickness, suggesting that smoking itself may play a role in the development of structural changes. No structural and cellular differences were observed in pulmonary arteries between smokers with severe COPD and smokers with mild/no COPD. In conclusion, in the small airways of smokers with severe COPD, there is an increased number of leukocytes, which is correlated with reduced expiratory flow, lung hyperinflation, carbon monoxide diffusion impairment, and radiologic emphysema, suggesting a role for this inflammatory response in the clinical progression of the disease.
AB - The lung pathology of severe chronic obstructive pulmonary disease (COPD) has been poorly investigated. We examined surgical specimens obtained from patients with severe (forced expiratory volume in 1 second [FEV 1] = 29 ± 3% predicted, n = 9) or mild/no airflow limitation (FEV 1 = 86 ± 5% predicted, n = 9) and similar smoking history. With histochemical and immunohistochemical methods we quantified the structural changes and the inflammatory cells in small airways and in muscular pulmonary arteries. As compared with smokers with mild/no COPD, smokers with severe COPD had an increased number of leukocytes in the small airways, which showed a positive correlation with the radiologic score of emphysema and with the value of residual volume, and a negative correlation with the values of FEV 1 and carbon monoxide diffusing capacity. The inflammatory process was characterized by an increase in CD8 + and CD4 + T-lymphocytes in the airway wall and by an increase in macrophages in the airway epithelium. When all smokers were considered together, the smoking history was correlated with both the airway wall and smooth muscle thickness, suggesting that smoking itself may play a role in the development of structural changes. No structural and cellular differences were observed in pulmonary arteries between smokers with severe COPD and smokers with mild/no COPD. In conclusion, in the small airways of smokers with severe COPD, there is an increased number of leukocytes, which is correlated with reduced expiratory flow, lung hyperinflation, carbon monoxide diffusion impairment, and radiologic emphysema, suggesting a role for this inflammatory response in the clinical progression of the disease.
KW - Airflow obstruction
KW - Airway inflammation
KW - Smoking
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U2 - 10.1164/rccm.2111084
DO - 10.1164/rccm.2111084
M3 - Article
C2 - 12091179
AN - SCOPUS:0036644755
VL - 166
SP - 105
EP - 110
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 1
ER -