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Published ahead of print on September 25, 2003, doi:10.1164/rccm.200306-727OC

Am. J. Respir. Crit. Care Med., Volume 168, Number 12, December 2003, 1495-1499

A more recent version of this article appeared on December 15, 2003
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Submitted on June 9, 2003
Accepted on September 22, 2003

Increased airway vascularity in newly diagnosed asthma using a high-magnification bronchovideoscope

Hiroshi Tanaka1*, Gen Yamada1, Toyohiro Saikai1, Midori Hashimoto1, Shintaro Tanaka1, Kazuhiko Suzuki1, Masaru Fujii1, Hiroki Takahashi1, and Shosaku Abe1

1 Third Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan

* To whom correspondence should be addressed. E-mail: tanakah{at}sapmed.ac.jp.

Hypervascularity in the bronchial wall is part of airway remodeling, but has remained an ill-defined process in asthma pathogenesis. Previous morphologic assessment has been limited to biopsy specimens, therefore a high-magnification bronchovideoscope (side-viewing type) was recently developed for less invasive examination of subepithelial vessels. We evaluated vascularity in the lower trachea using this novel scope in 12 normal controls, 13 patients with chronic obstructive pulmonary disease (COPD), and 24 subjects with stable asthma; 8 were steroid-naive newly diagnosed asthma (group A) and 16 had been treated with inhaled corticosteroids for over five years (group B). The redness of bronchial mucosa in patients with asthma observed by conventional fiberoptic bronchoscopy proved to be due to a fine vascular network. Morphometric measurements of subepithelial vessels showed that both vessel area density and vessel length density were significantly (p<0.0001) increased in subjects with asthma as compared with controls and patients with COPD. The degree of increase in vessels did not differ between group A and B. The increase in subepithelial vessels of the airway is present even in newly diagnosed asthma. This novel bronchovideoscope is useful for assessment of vessel network in the surface of the airway lumen in vivo.
Key words: asthma, COPD, angiogenesis, bronchovideoscope, airway remodeling




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