Quantitative analysis of bronchial wall vascularity in the medium and small airways of patients with asthma and COPD
Quantitative analysis of bronchial wall vascularity in the medium and small airways of patients with asthma and COPD
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DOI：
10.1378/chest.127.3.965
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发表时间：
2005-03-01
期刊：
影响因子：
9.6
通讯作者：
Abe, S
中科院分区：
文献类型：
--
作者：
Hashimoto, M;Tanaka, H;Abe, S
背景：粘膜下血管增多是哮喘患者气道重塑的一部分，但其在小气道中的存在及其对气流受限的作用仍存在争议。方法：我们研究了哮喘(n=9)和慢性阻塞性肺疾病(COPD)患者(n=11)和8名对照组的中气道(内径2~5 mm)和小气道(内径2 mm)之间的支气管壁血管和血管生成细胞。结果：与COPD组和对照组比较，哮喘患者中、小气道血管数均显著增加(P<0.01)，中、小气道血管百分率显著增加(P<0.01)。中度哮喘患者的血管密度明显高于轻度哮喘患者(p<；0.01)，且哮喘患者的血管生成因子阳性细胞数较对照组增多。在哮喘患者中，FEV1预测百分比与中气道内侧的血管数(r=-0.85；p<；0.01)或血管百分比(r=-0.72；p<；0.03)呈负相关，而在小气道则未见相关。结论：哮喘患者中、小气道血管数较COPD患者明显增多，COPD患者小气道血管面积增加，而哮喘患者无明显变化。哮喘患者的气流受限可能与中气道内侧的血管增多有关，但与小气道的血管增多无关。
Background: Submucosal hypervascularity is part of airway remodeling in patients with asthma; however, its existence in the small airways and its contribution to airflow limitation remain controversial.Methods: We investigated bronchial wall vascularity and angiogenic cells between medium airways (inner diameter, 2 to 5 mm) and small airways (inner diameter, < 2 mm) in patients with asthma (n = 9) and COPD (n = 11), and in 8 control subjects. The lung specimens obtained during surgery were immunostained to detect CD31, CD34, vascular endothelial growth factor, and basic fibroblast growth factor.Results: The number of vessels in both the medium and small airways in patients with asthma was significantly (p < 0.01) increased compared to those in patients with COPD and control subjects, and the percentage of vascularity was significantly (p < 0.01) increased in the medium airways in asthma patients and in the small airways in COPD patients. Patients with moderate asthma showed a greater increase in vascularity than those with mild asthma (p < 0.01), and the number of angiogenic factor-positive cells increased in asthma patients compared with control subjects. In asthmatic subjects, inverse correlations were found between FEV1 percentage of predicted and the number of vessels (r = -0.85; p < 0.01), or the percentage of vascularity (r = -0.72; p < 0.03) in the inner area of the medium airways, but they were not found for the small airways. In COPD patients, no correlations were demonstrated.Conclusions: The number of vessels in the medium and small airways in asthma patients shows a greater increase than those in COPD patients, and the vascular area in the small airways is increased in COPD patients but not in asthma patients. Enhanced vascularity in the inner area of the medium airways, but not in the small airways, might contribute to airflow limitation in asthma patients.