Negri Elnara M, Hoelz Cristiane, Barbas Carmen S V, Montes Gregorio Santiago, Saldiva Paulo H N, Capelozzi Vera L
Department of Pathology, the Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil.
Pathol Res Pract. 2002;198(5):355-61. doi: 10.1078/0344-0338-00266.
This study aimed at evaluating acute pulmonary remodeling, focusing on alterations of fibers of the collagenous and elastic systems in ARDS in the exudative phase according to the etiology of the disease. ARDS patients (n = 23), who died in our institution between 1989 and 1997, were retrospectively studied. Ten patients who died in accidents, without any pathological changes in the lung, and ten patients with Congestive Heart Failure (CHF), submitted to mechanical ventilation, were used as control groups. Histological slides were sampled from the autopsied lungs and stained by the Picrosirius and Weigert's resorcin-fuchsin methods. The fiber content of the collagenous and elastic systems of the alveolar septum was measured by image analysis. All patients were in the early ARDS phase (n = 23), 10 pulmonary and 13 extra-pulmonary diseases. Collagen content was greater in pulmonary (1.23+/-0.27) than in extra-pulmonary (0.92+/-0.39) ARDS in the early phase of the disease (p = 0.05). No differences were observed concerning the elastic fibers' content. Extracellular matrix (ECM) remodeling occurs early in the development of acute lung injury and appears to depend on the site of initial insult (pulmonary or extrapulmonary). The present study provides the basis for a prospective, controlled investigation.
本研究旨在评估急性肺重塑，重点关注根据疾病病因，在急性呼吸窘迫综合征（ARDS）渗出期胶原和弹性系统纤维的改变。对1989年至1997年间在我们机构死亡的ARDS患者（n = 23）进行了回顾性研究。将10名死于意外且肺部无任何病理变化的患者以及10名接受机械通气的充血性心力衰竭（CHF）患者作为对照组。从尸检肺中采集组织学切片，并用天狼星红和魏格特间苯二酚品红法染色。通过图像分析测量肺泡间隔胶原和弹性系统的纤维含量。所有患者均处于ARDS早期（n = 23），其中10例为肺部疾病，13例为肺外疾病。在疾病早期，肺部ARDS（1.23±0.27）的胶原含量高于肺外ARDS（0.92±0.39）（p = 0.05）。弹性纤维含量未观察到差异。细胞外基质（ECM）重塑在急性肺损伤发展早期就会发生，并且似乎取决于初始损伤部位（肺部或肺外）。本研究为前瞻性对照研究提供了基础。
