Bronchus Morphometry. Correlations between Morphometric Data and Lung Function Parameters in Obstructive Airway Disease

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Abstract
It is not clear which morphological alterations cause changes of functional parameters in obstructive airway disease; therefore, samples from bronchi of 29 deceased patients who underwent lung function test within 3 years prior to death were studied by morphometric methods. The volume densities of bronchial lumen, bronchial soft tissue (bronchial tissue without cartilage), cartilage, smooth muscle, bronchial glands and connective tissue were assessed in relation to two reference systems, namely (1) whole bronchus including lumen, and (2) bronchus wall tissue. Also, the surface density of bronchial basement membrane, the ratio surface density of basement membrane to volume density of bronchial lumen and the correlation of volume density of bronchial glands with volume density of smooth muscles were evaluated. The morphometric parameters were correlated with the two main parameters of airway obstruction, i.e. with RAW and FEW1 The statistic analyses showed a significant correlation between the volume densities of muscles and glands and of surface density of the bronchial basement membrane with functional parameters. Muscle volume correlated somewhat better with RAW (2 p < 0.01) than with FEV1 (2 p < 0.05). On the other hand, glandular volume correlated better with FEV1 (2 p < 0.025) than with RAW (2 p < 0.05). An especially good correlation was found between the volume densities of bronchial glands and of smooth muscles (2 p < 0.005). This shows that the muscular and glandular thickening are morphological signs of obstructive disease. The results are more conclusive if the morphometric parameters are computed in relation to the reference volume I. They confirm that both the muscle constriction and mucus plugging influence airway obstruction. The decrease of the surface density of the basement membrane may be a consequence of muscular and glandular thickening. The pathogenetic mechanisms are discussed in detail.

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