Ferreira José Reis, Monteiro Miguel B, Tavares Fernanda, Serrano Isabel, Monteiro Emanuel, Mendes Carla P, Alves-Pereira Mariana, Branco Nuno A A Castelo
Unidade de Estudo Funcional Respiratório, Hospital da Força Aérea, Lisboa.
Rev Port Pneumol. 2006 Mar-Apr;12(2):93-105.
Vibroacoustic disease (VAD) is the whole-body pathology caused by excessive exposure to LFN. For the past 25 years, it has been know that low frequency noise (LFN, < 500 Hz, including infrasound) targets the respiratory system. In LFN-exposed rodents, the morphological changes of respiratory tract tissue partially explained some respiratory symptoms reported by VAD patients. However, many questions remain unanswered. Recently, some volunteer VAD patients underwent bronchoscopy in order to ascertain possible damage that could be associated with their respiratory complaints.
Fourteen fully-informed and volunteer VAD patients were submitted to bronchoscopy, and biopsies were removed for analysis.
All patients exhibited small submucosal vascular-like lesions near the spurs, consisting of increased collagen and elastin fibres. Histology disclosed cilliary abnormalities, basal membrane hyperplasia, and thickening of vessel walls. In five patients, collagen bundles appeared degenerative and disrupted. No inflammatory process was ever identified, and no differences were seen between smokers and non-smokers.
Data is in accordance with what was observed in LFN-exposed animal models and also in 8 VAD patients who developed lung tumours. Collagen disruption and degeneration was also observed in electron microscopy images of the respiratory tract of LFN-exposed rodents. Thickened blood and lymphatic vessel walls have been consistently seen in images of VAD patients and of LFN-exposed rodents. During bronchoscopy performed by other reasons, this sort of structural aspects is not frequently seen. Taken together, it is strongly suggested that these findings could be VAD-specific.
振动声学疾病（VAD）是由过度暴露于低频噪声（LFN）引起的全身性病理状况。在过去25年中，人们已经知道低频噪声（LFN，<500Hz，包括次声）会影响呼吸系统。在暴露于LFN的啮齿动物中，呼吸道组织的形态变化部分解释了VAD患者报告的一些呼吸道症状。然而，许多问题仍未得到解答。最近，一些VAD志愿者患者接受了支气管镜检查，以确定可能与其呼吸道症状相关的损伤。
14名充分知情的VAD志愿者患者接受了支气管镜检查，并取活检组织进行分析。
所有患者在隆突附近均表现出小的黏膜下血管样病变，由增加的胶原纤维和弹性纤维组成。组织学检查发现纤毛异常、基底膜增生和血管壁增厚。5名患者的胶原束出现变性和断裂。未发现炎症过程，吸烟者和非吸烟者之间也未观察到差异。
数据与在暴露于LFN的动物模型以及8名患肺癌的VAD患者中观察到的情况一致。在暴露于LFN的啮齿动物呼吸道的电子显微镜图像中也观察到了胶原断裂和变性。在VAD患者和暴露于LFN的啮齿动物的图像中一直可以看到增厚的血管壁和淋巴管壁。在因其他原因进行支气管镜检查时，这种结构方面的情况并不常见。综上所述，强烈提示这些发现可能是VAD特有的。
