Am. J. Respir. Crit. Care Med., Vol 153, No. 2, Feb 1996, 638-643.
Morphologic aspects of airways of patients with pulmonary emphysema followed by bronchial asthma-like attack
M Haraguchi, S Shimura and K Shirato
First Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
Morphometric analysis of airways was performed in autopsied lungs from four
patients with pulmonary emphysema (PE) followed by bronchial- asthma
(BA)-like attacks (Group PE+BA) (four males, 72 +/- 9 yr). The results were
compared with those from five pulmonary emphysema patients (Group PE) (five
males, age 71 +/- 4 hr), three patients with bronchial asthma (Group BA)
(one female and two males, age 65 +/- 7 yr), and four control subjects with
no pulmonary diseases (Group Cont) (one female, three males, age 64 +/- 4
yr). The proportion of gland area to bronchial wall (gland%), ratio of
goblet-cell occupancy to the total epithelial layer (goblet%), thickness of
the basement membrane, amount of intraluminal mucus (mucus occupying ratio;
MOR%), and number of various cell types per square millimeter in airway
walls in a section 4 microns thick were measured in central (3 to 8 mm
diameter) and peripheral airways (2 mm or less diameter). Gland% for the
PE+BA group was significantly greater than that for the Cont group, whereas
it did not differ significantly from that of the PE or BA groups. Goblet%
and thickness of the basement membrane in central and/or peripheral airways
in Group PE+BA were significantly greater than those in Group Cont, whereas
those in Group PE were similar to those in Group Cont. Although not
statistically significant, MOR% in central and peripheral airways from
Group PE+BA showed a similar value to that in Group BA, whereas MOR% in
Group PE was the same as that in Group Cont. The eosinophil number in
peripheral airways walls in Group PE+BA showed a similar value to that in
Group BA, which was significantly greater than in Group Cont. Other cells
(macrophages, lymphocytes, and neutrophils) showed similar values among
Groups PE+BA, PE, and BA. The number of eosinophils in central and/or
peripheral airways correlated significantly with both goblet% and BMT,
whereas other cells did not. These findings indicate that the airways of
Group PE+BA are morphologically similar to those of Group BA, suggesting a
combination of pulmonary emphysema with bronchial asthma.
