Some morphological factors of resistance of the bronchial wall to the development of chronic obstructive lung disease in smoking individuals
Elena A. Gereng, Irina V. Suhodolo, Raisa I. Pleshko, Ekaterina B. Bukreeva, Anna А. Bulanova, Ivan S. Kremis, Tatyana S. Klyushina
Siberian State Medical University of Minzdrav of Russia, Tomsk, Russia
e-gereng@mail.ru
Keywords: chronic obstructive pulmonary disease, bronchial biopsy, bronchial vascular remodeling
Abstract
According to current
epidemiological studies, chronic obstructive pulmonary disease (COPD)
develops in only 15-20 % of smokers. This suggests that exposure to
tobacco smoke is just a trigger of the pathological process, and other
pathophysiological factors play a key role in the development of COPD.
The aim of the study was to perform morphological analysis of bronchial
mucosa features in smokers with and without chronic obstructive
pulmonary disease. Material and research methods. Morphological and
electron-microscopic analysis of biopsy samples of the bronchial mucosa
of smoking patients with ( n = 40) and without ( n = 30) chronic
obstructive pulmonary disease was carried out. Тhe study involved men
(80.2 % of men) and women aged 42 to 67 years (62.3 ± 2.24 years) with
smoking experience of more than 20 years and smoking intensity of 20-45
pack-years. In the main group was a verified diagnosis of COPD. All
patients of the studied groups underwent morphological, morphometric
counting of bulk densities of various types of epithelial cells and
structures of their lamina propria of the bronchial mucosa, as well as
the density of inflammatory infiltrate and various cell populations,
immunohistochemical (typing of CD4- and CD8-positive lymphocytes,
expression of transforming growth factor β1 receptors) and electron
microscopic analysis of bronchobioptates. Results and discussion.
Smokers without chronic obstructive pulmonary disease develop exudative
inflammation, which does not violate the structural architectonics of
the epithelial layer, but causes activation of protein-synthetic and
energy processes in the epithelial cells of the bronchial wall. With
prolonged exposure to tobacco smoke associated with the development of
chronic obstructive pulmonary disease, chronic neutrophilic inflammation
forms in the bronchial mucosa, leading to a violation of the functional
morphology of the vessels and epithelial cells of the bronchial mucosa,
followed by remodeling of the bronchial wall.
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