Epithelial desquamation in asthma: artifact or pathology?
Epithelial desquamation in asthma: artifact or pathology?
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哮喘中的上皮脱落：人为因素还是病理原因？
DOI：
10.1164/ajrccm.162.6.2001041
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Fahy,JV
中科院分区：
文献类型：
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作者：
Ordonez,C;Ferrando,R;Hyde,DM;Wong,HH;Fahy,JV
为了确定在哮喘受试者的支气管内活检中观察到的支气管上皮剥脱是真实的病理特征还是组织取样的伪影，我们分析了14名轻度和中度哮喘受试者和12名健康受试者的支气管活检中的上皮完整性。在每例受试者中，在支气管镜检查期间从大气道采集4 - 8份支气管活检标本，固定在4%多聚甲醛中，包埋在糖甲基丙烯酸酯中，切成2 μ M切片，并用甲苯胺蓝染色。使用摄像机将每个活检组织的4 × 4图像复制到计算机文件中，并沿基底膜（位于完全剥脱上覆上皮的区域下方）、单层基底细胞覆盖的区域和完整上皮区域画线并进行沿着测量。我们发现，基底膜上皮脱落的百分比在健康和哮喘受试者中相似（分别为14.8 ± 11.8%和11.4 ± 9.8%，p = 0.38）;两组中基底膜被单层基底细胞覆盖的百分比也相似（46.4 ± 11.0对比54.5 ± 9.8%，p = 0.11）。在哮喘患者中，我们发现基底膜被裸露上皮或单层基底细胞覆盖的百分比与FEV 1预测值百分比或PC 20乙酰甲胆碱之间无显著相关性。我们的结论是，在支气管内膜活检的支气管上皮剥脱的哮喘患者稳定的轻度和中度疾病是一个伪像的组织采样，并不是一个真正的病理特征的疾病，气道上皮剥脱的程度是不相关的气道狭窄的严重程度或支气管高反应性的严重程度。
To determine whether the denudation of the bronchial epithelium observed in endobronchial biopsies from asthmatic subjects is a true pathologic feature or an artifact of tissue sampling, we analyzed epithelial integrity in bronchial biopsies from 14 subjects with mild and moderate asthma and 12 healthy subjects. In each subject, 4 to 8 bronchial biopsies were taken from large airways during bronchoscopy, fixed in 4% paraformaldehyde, embedded in glycomethacrylate, cut into 2- μ M sections, and stained with toluidine blue. A × 4 image of each biopsy was copied to a computer file using a video camera, and lines were drawn and measured along the basement membrane underlying areas completely denuded of overlying epithelium, areas covered by a single layer of basal cells, and areas of intact epithelium. We found that the percentage of basement membrane that was denuded of epithelium was similar in the healthy and asthmatic subjects (14.8 ± 11.8 versus 11.4 ± 9.8% respectively, p = 0.38); the percentage of basement membrane that was covered by a single layer of basal cells was also similar in the two groups (46.4 ± 11.0 versus 54.5 ± 9.8%, respectively, p = 0.11). In the asthmatic subjects, we found no significant correlation between the percentage of basement membrane covered by denuded epithelium or by a single layer of basal cells and the FEV1percentage of predicted or the PC20methacholine. We conclude that denudation of bronchial epithelium in endobronchial biopsies from asthmatic subjects with stable mild and moderate disease is an artifact of tissue sampling and is not a true pathologic feature of the disease, and that the extent of airway epithelial denudation is not correlated with the severity of airway narrowing or the severity of bronchial hyperresponsiveness.