Am. J. Respir. Crit. Care Med., Vol 149, No. 6, Jun 1994, 1575-1582.
Pathophysiologic correlations in lymphoid interstitial pneumonia
DD Collie, PM Warren, I Begara, L Lujan and NJ Watt
Department of Veterinary Pathology, Royal (Dick) School of Veterinary Studies, Roslin, Midlothian, United Kingdom.
Effective alveolar volume, diffusing capacity for carbon monoxide (DCOsb),
volume-corrected diffusing capacity (D/VA), static lung compliance (Cst),
and lung distensibility were measured in 16 sheep seropositive for
maedi-visna virus (MVV) immediately before they were killed. Lungs were
inflation-fixed, and the left lung was randomly sampled for morphometric
analysis. The total lung weight, total fixed lung volume, volume densities
of tissue (Vvt) and air (Vva), and the alveolar surface density were
measured and correlated with the physiologic measurements. The density of
surface forces could not account for the variation in the distensibility of
the lungs, indicating that tissue-related forces may be important in
determining lung distensibility in lymphoid interstitial pneumonia (LIP)
associated with MVV infection. Possible sources of tissue-related forces
are the contractile tissue associated with lung parenchyma, airways, or
vasculature. When DCOsb was corrected for volume, a strong negative
correlation with Vvt was noted, indicating that factors distinct from
lung-volume reduction are important in limiting gas exchange in LIP
associated with MVV infection. More sheep demonstrated abnormal D/VA values
than any other physiologic measurement, with reduced values being apparent
even in sheep considered clinically normal and with little or no
morphometric evidence of lung disease. Measurements of diffusing capacity
are thus considered the most sensitive functional index of disease
progression.