Chen Fen-hua, Chen Zhuang-gui, Chen Hong, Ji Jing-zhi, Chen Yan-feng, Peng Bi-xiu, Shioda Sei-ji
Department of Pediatrics, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
Zhonghua Yi Xue Za Zhi. 2006 Feb 21;86(7):468-71.
To investigate the correlation between the reticular basement membrane thickness and the airway wall remolding in asthma patients.
Lung tissues were obtained from 5 patients who died from asthma, 3 males and 2 females, aged 45 +/- 16 (fatal asthma group), 5 asthmatics who died of diseases unrelated to asthma, 3 males and 2 females, aged 47 +/- 13, (non-fatal asthma group), and 5 dead patients without asthma, 3 males and 2 females, aged 24 +/- 14 (control group) to select 41, 38, and 43 transverse sections of tracheae respectively. The samples of tracheae were divided into cartilaginous and membranous airways by light microscopy (x100). The thickness of reticular basement membrane and the dimensions of the airway wall, including the smooth muscle area, submucosal gland area, inner and outer wall areas, and lumen area were measured. The correlations of reticular basement membrane thickness with the airway changes were analyzed.
The reticular basement membrane was significantly thicker in both cartilaginous and membranous airways in the fatal and non-fatal asthma groups than in the control group (all P < 0.05). The submucosal gland area of the fatal asthma group was significantly larger than those of the non-fatal asthma group and control group (both P < 0.05). The inner wall area of the cartilaginous airway of the fatal asthma group was significantly larger than that of the non-fatal asthma group (P < 0.05); however, the inner wall area of the membranous airway of the fatal asthma group was not significantly different from that of the non-fatal asthma group. The outer wall areas of cartilaginous and membranous airways of the fatal asthma group were both significantly larger than those of the other 2 groups (all P < 0.05). There was no significant difference in the lumen areas of cartilaginous and membranous airways between the fatal and non-fatal asthma groups. The reticular basement membrane thickness was correlated with the smooth muscle area (P < 0.05), submucosal gland area (P < 0.05), and inner wall area (P < 0.01) of the corresponding bronchi in regard to the cartilaginous airway; and was correlated with the smooth muscle area (P < 0.05) and inner wall area (P < 0.01) of the corresponding bronchi in regard to the membranous airway, but was not correlated with the airway size, lumen area, and outer wall area in regard to the 2 kinds of airways.
The reticular basement membrane thickness of central airway reflects the airway remolding of the central airway and the changes of smooth muscle and inner wall of the peripheral airway. It is worthwhile to do end bronchial biopsy to measure the reticular basement membrane thickness so as to assess the pathology of the airway and to conduct long-term follow-up among the asthma patients.
探讨哮喘患者网状基底膜厚度与气道壁重塑之间的相关性。
从5例死于哮喘的患者（3例男性，2例女性，年龄45±16岁，致死性哮喘组）、5例死于与哮喘无关疾病的哮喘患者（3例男性，2例女性，年龄47±13岁，非致死性哮喘组）以及5例无哮喘的死亡患者（3例男性，2例女性，年龄24±14岁，对照组）获取肺组织，分别选取气管的41、38和43个横切面。通过光学显微镜（×100）将气管样本分为软骨性气道和膜性气道。测量网状基底膜厚度以及气道壁的尺寸，包括平滑肌面积、黏膜下腺面积、内壁和外壁面积以及管腔面积。分析网状基底膜厚度与气道变化之间的相关性。
致死性和非致死性哮喘组的软骨性和膜性气道中网状基底膜均显著厚于对照组（均P<0.05）。致死性哮喘组的黏膜下腺面积显著大于非致死性哮喘组和对照组（均P<0.05）。致死性哮喘组软骨性气道的内壁面积显著大于非致死性哮喘组（P<0.05）；然而，致死性哮喘组膜性气道的内壁面积与非致死性哮喘组无显著差异。致死性哮喘组软骨性和膜性气道的外壁面积均显著大于其他两组（均P<0.05）。致死性和非致死性哮喘组软骨性和膜性气道的管腔面积无显著差异。对于软骨性气道，网状基底膜厚度与相应支气管的平滑肌面积（P<0.05）、黏膜下腺面积（P<0.05）和内壁面积（P<0.01）相关；对于膜性气道，网状基底膜厚度与相应支气管的平滑肌面积（P<0.05）和内壁面积（P<0.01）相关，但与两种气道的气道大小、管腔面积和外壁面积无关。
中央气道的网状基底膜厚度反映了中央气道的气道重塑以及外周气道平滑肌和内壁的变化。进行支气管活检测量网状基底膜厚度以评估气道病理并对哮喘患者进行长期随访是值得的。
