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Published ahead of print on September 25, 2003, doi:10.1164/rccm.200308-1107OC

Am. J. Respir. Crit. Care Med., Volume 169, Number 1, January 2004, 120-124

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Submitted on August 8, 2003
Accepted on September 20, 2003

The number of alveoli in the human lung

Matthias Ochs1*, Jens R Nyengaard2, Anja Jung1, Lars Knudsen1, Marion Voigt1, Thorsten Wahlers3, Joachim Richter1, and Hans Jorgen G Gundersen4

1 Anatomy, Division of Electron Microscopy, University of Gottingen, Gottingen, Germany, 2 Stereological Research Laboratory and Electron Microscopy Laboratory, University of Aarhus, Aarhus, Denmark, 3 Cardiothoracic and Vascular Surgery, University of Jena, Jena, Germany, 4 Stereological Research Laboratory and Electron Microscopy Laboratory, University of Aarhus, Aarhus, Denmark; California National Primate Research Center, University of California Davis, Davis, CA, USA

* To whom correspondence should be addressed. E-mail: mochs{at}gwdg.de.

The number of alveoli is a key structural determinant of lung architecture. A design-based stereological approach was used for the direct and unbiased estimation of alveolar number in the human lung. The principle is based on two-dimensional topology in three-dimensional space and is free of assumptions on the shape, size or spatial orientation of alveoli. Alveolar number is estimated by counting their openings at the level of the free septal edges, where they form a two-dimensional network. Mathematically, the Euler number of this network is estimated using physical disectors at a light microscopical level. In six adult human lungs, the mean alveolar number was 480 million (range: 274 to 790 million; CV: 37%). Alveolar number was closely related to total lung volume with larger lungs having considerably more alveoli. The mean size of a single alveolus was rather constant with 4.2x106µm3 (range: 3.3 to 4.8x106µm3; CV: 10%), irrespective of the lung size. One mm3 lung parenchyma would then contain around 170 alveoli. The method proved to be very efficient and easy to apply in practice. Future applications will show this approach to be an important addition to design-based stereological methods for the quantitative analysis of lung structure.
Key words: connectivity, disector, Euler number, morphometry, stereology




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