慢性阻塞性肺病
医学
气道
肺活量测定
气道阻塞
心脏病学
肺
组织病理学
内科学
病理
通风(建筑)
外科
哮喘
机械工程
工程类
作者
Stijn E. Verleden,Jeroen Hendriks,Annemiek Snoeckx,Cindy Mai,Yves Mentens,W Callebaut,Bruno De Belie,Paul Van Schil,Veronique Verplancke,Annelies Janssens,Joseph Jacob,Ashkan Pakzad,Thomas M. Conlon,Gönül Güvenç,Ali Önder Yildirim,Patrick Pauwels,Senada Koljenović,Johanna M. Kwakkel-Van-Erp,Thérèse S. Lapperre
标识
DOI:10.1164/rccm.202301-0132oc
摘要
Small airway disease is an important pathophysiological feature of COPD. Recently, pre-COPD has been put forward as potential precursor stage of COPD, defined by abnormal spirometry or significant emphysema on CT in the absence of airflow obstruction.We collected whole lungs/lung lobes from patients with emphysematous pre-COPD (n=10), COPD GOLD I (n=6), GOLD II (n=6), GOLD III/IV (n=7) and controls (n=10) which were analyzed using CT and microCT. The degree of emphysema and the number and morphology of small airways was compared between the different groups and further correlations were investigated with physiologic measures. Airway and parenchymal pathology was also validated with histopathology.The number of transitional bronchioles (TrB)/mL and terminal bronchioles (TB)/mL was significantly lower in pre-COPD, GOLD I, GOLD II and GOLD III/IV compared to controls. In addition, the number of alveolar attachments of the TrB and TB was also lower in pre-COPD and all COPD groups compared to controls. We did not find any differences between the pre-COPD and COPD group in either CT or microCT measures. The % of emphysema on CT showed the strongest correlation with the number of small airways, also in patients without airflow obstruction. Histopathology showed an increase in the mean chord length and a decrease in the alveolar surface density in pre-COPD and all GOLD stages compared to control.Lungs of patients with emphysematous pre-COPD already show lower small airway number and airway remodeling and in the absence of physiologic airway obstruction.
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