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Int J Chron Obstruct Pulmon Dis. 2014 Sep 1;9:927-32. doi: 10.2147/COPD.S52478. eCollection 2014.

Central airways remodeling in COPD patients.

Author information

1
Unit of Respiratory Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
2
Department of Respiratory Medicine, Spedali Civili di Brescia, Brescia, Italy.
3
Department Bronchoscopy, Spedali Civili di Brescia, Brescia, Italy.
4
Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.

Abstract

BACKGROUND:

The contribution to airflow obstruction by the remodeling of the peripheral airways in chronic obstructive pulmonary disease (COPD) patients has been well documented, but less is known about the role played by the large airways. Few studies have investigated the presence of histopathological changes due to remodeling in the large airways of COPD patients.

OBJECTIVES:

The aim of this study was to verify the presence of airway remodeling in the central airways of COPD patients, quantifying the airway smooth muscle (ASM) area and the extracellular matrix (ECM) protein deposition, both in the subepithelial region and in the ASM, and to verify the possible contribution to airflow obstruction by the above mentioned histopathological changes.

METHODS:

Biopsies of segmental bronchi spurs were performed in COPD patients and control smoker subjects and immunostained for collagen type I, versican, decorin, biglycan, and alpha-smooth muscle actin. ECM protein deposition was measured at both subepithelial, and ASM layers.

RESULTS:

The staining for collagen I and versican was greater in the subepithelial layer of COPD patients than in control subjects. An inverse correlation was found between collagen I in the subepithelial layer and both forced expiratory volume in 1 second and ratio between forced expiratory volume in 1 second and forced vital capacity. A statistically significant increase of the ASM area was observed in the central airways of COPD patients versus controls.

CONCLUSION:

These findings indicate that airway remodeling also affects the large airways in COPD patients who have greater deposition of ECM proteins in the subepithelial layer and a larger smooth muscle area than control smoker subjects. These changes may contribute to chronic airflow obstruction in COPD patients.

KEYWORDS:

COPD; airway smooth muscle; central airways; proteoglycans; remodeling

PMID:
25214779
PMCID:
PMC4159070
DOI:
10.2147/COPD.S52478
[Indexed for MEDLINE]
Free PMC Article

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