Changes in elastic fibres in the small airways and alveoli in COPD
Changes in elastic fibres in the small airways and alveoli in COPD
复制标题
DOI：
10.1183/09031936.00017207
复制
发表时间：
2008-05-01
影响因子：
24.3
通讯作者：
Merrilees, M. J.
中科院分区：
文献类型：
--
作者：
Black, P. N.;Ching, P. S. T.;Merrilees, M. J.
小气道是慢性阻塞性肺疾病（COPD）气流阻塞的主要部位。这是由于肺泡弹性蛋白损失和小气道纤维化造成的。在本研究中，假设肺泡中弹性纤维的变化可能与小气道中弹性纤维的类似减少同时发生。研究了因支气管癌接受肺叶切除术的患者的组织块。患者被分类为 COPD（一秒用力呼气量 (FEV1) < 80% 预测值，FEV1/用力肺活量 (FVC) < 0.7）或对照组（FEV1 >= 80% 预测值，FEV1/FVC >= 0.7）。使用弹性范吉森染色使弹性纤维可视化，并使用点计数将弹性纤维的体积分数（v/f）确定为组织体积的百分比。弹性纤维网络也可以通过共焦显微镜观察到。COPD 患者肺泡中弹性纤维的 v/f 为 18.6%，对照组为 32.8%。在气道中，COPD 的 v/f 为 14.6%，对照组为 25.5%。 FEV1%预测值与肺泡和小气道的v/f相关。慢性阻塞性肺疾病的小气道和肺泡中弹性纤维的体积分数减少到类似程度，并且两者都与气流阻塞的程度相关。小气道中弹性纤维的损失可能导致慢性阻塞性肺病中气流阻塞的发生。
Small airways are the major site of airflow obstruction in chronic obstructive pulmonary disease (COPD). This is attributed to loss of elastin in alveoli and fibrosis in small airways. In the present study, it was hypothesised that changes to elastic fibres in alveoli might be paralleled by a similar reduction in elastic fibres in small airways.Tissue blocks from patients who had lobectomy for bronchial carcinoma were studied. Patients were classified as COPD (forced expiratory volume in one second (FEV1) < 80% predicted, FEV1/ forced vital capacity (FVC) < 0.7) or controls (FEV1 >= 80% pred, FEV1/FVC >= 0.7). Elastic fibres were visualised using Elastic van Gieson staining and the volume fraction (v/f) of elastic fibres was determined as a percentage of tissue volume using point counting. Elastic fibre networks were also visualised by confocal microscopy.The v/f for elastic fibres in alveoli was 18.6% for COPD and 32.8% in controls. In the airways the v/f was 14.6% for COPD and 25.5% in controls. FEV1% predicted was correlated with v/f in both alveoli and small airways.The volume fraction of elastic fibres was reduced to a similar extent in small airways and alveoli in chronic obstructive pulmonary disease and both were correlated with the extent of airflow obstruction. Loss of elastic fibres in small airways may contribute to the development of airflow obstruction in chronic obstructive pulmonary disease.