Source: Annual Congress 2010 - COPD: treatment and monitoring
Disease area: Airway diseases

Abstract

Airway remodeling is present in patients with COPD and is considered the most important contributor to airflow limitation. Aim of the work: To study the airway structural abnormalities and the role of mast cells in mild COPD. Methods: Thirty patients having mild COPD were subjected to sputum analysis and fiberoptic bronchoscopic biopsies from the main and segmental bronchi. BAL was obtained from segmental bronchi. Results: At the level of mucosa there was infiltration by macrophages, lymphocytes and few numbers of neutrophils. Congestion, epithelial shedding and squamous metaplasia were more prevalent than in the central airways. At level of the submucosa there was goblet cell hyperplasia in 70% of cases. The muscle layer thickness was increased in 80% of peripheral airways in comparison to 56.7% in the central ones and 83.3% showed thick fibrosed wall and shed epithelium in comparison to 40.0% in central airways

Comparison between biopsy findings of central and peripheral airways

Results of biopsy	Number of patients with central airway abnormalities	Number of patients with peripheral al airway abnormalities	Z- test
Mucosa and Submucosa:Infiltration, congestion, epithelial shedding & squamous metaplasia	0	21	*5.4
Infiltration, congestion & epithelial shedding	17	8	*2.1
Infiltration only	13	1	*3.4
Increased goblet cells	0	21	*5.4
Mucous gland hypertrophy,infiltration & congestion	14	5	*2.2
Fibrosis	12	25	*3.2
Increased thickness of muscle layer > 50 %	17	24	*1.7

* = Significant difference.

.Conclusion: The pathological hallmark of COPD was mainly at the level of the small airways both at the level of the cellular components of BAL and at the level of histopathology.

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Citations should be made in the following way:
O. Mansour, A. Ali, M. Abd El-Wahed, N. Azab, S. El-dahdouh (Shebin Elkom, Egypt). Pattern of airway inflammation and remodeling in mild chronic obstructive pulmonary disease. Eur Respir J 2010; 36: Suppl. 54, 1333

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