Artículos de revistas
Small Airway Remodeling in Idiopathic Interstitial Pneumonias: A Pathological Study
Fecha
2010Registro en:
RESPIRATION, v.79, n.4, p.322-332, 2010
0025-7931
10.1159/000235722
Autor
MELLO, George Castro Figueira de
CARVALHO, Carlos Roberto Ribeiro
KAIRALLA, Ronaldo Adib
SALDIVA, Paulo Hilario Nascimento
FERNEZLIAN, Sandra
SILVA, Luiz Fernando Ferraz
DOLHNIKOFF, Marisa
MAUAD, Thais
Institución
Resumen
Background: Few studies have addressed small airway (SA) histopathological changes and their possible role in the remodeling process in idiopathic interstitial pneumonias. Objectives: To study morphological, morphometrical and immunohistochemical features of SA in idiopathic pulmonary fibrosis (usual interstitial pneumonia, UIP) and nonspecific interstitial pneumonia (NSIP). Methods: We analyzed SA pathology in lung biopsies from 29 patients with UIP and 8 with NSIP. Biopsies were compared with lung tissue from 13 patients with constrictive bronchiolitis (CB) as positive controls and 10 normal autopsied control lungs. We semi-quantitatively analyzed SA structure, inflammation, architectural features and the bronchiolar epithelial immunohistochemical expression of TGF-beta, MMP-2, 7, 9, and their tissue inhibitors (TIMP-1, 2). Results: Compared to controls, patients with UIP, NSIP and CB presented increased bronchiolar inflammation, peribronchiolar inflammation and fibrosis and decreased luminal areas. UIP patients had thicker walls due to an increase in most airway compartments. NSIP patients presented increased epithelial areas, whereas patients with CB had larger inner wall areas. All of the groups studied presented increased bronchiolar expression of MMP-7 and MMP-9, compared to the controls. Conclusion: We conclude that SAs are pathologically altered and may take part in the lung-remodeling process in idiopathic interstitial pneumonias. Copyright (C) 2009 S. Karger AG, Basel