The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul's Hospital, Depts. of Medicine and Pathology, University of British Columbia, Canada.
COPD. 2009 Dec;6(6):421-31. doi: 10.3109/15412550903341471.
Progression of COPD is associated with a measurable increase in small airway wall thickness resulting from a repair and remodeling process that involves fibroblasts of the epithelial mesenchymal trophic unit (EMTU). The present study was designed to examine the organization of fibroblasts within the lamina propria of small airways with respect to their contacts with the epithelium and with each other in persons with COPD. Transmission electron microcopy (TEM) and three-dimensional (3D) reconstructions of serial TEM sections were used to estimate the frequency and determine the nature of the contacts between the epithelium and fibroblasts within the EMTU in small airways from 5 controls (smokers with normal lung function), from 6 persons with mild (GOLD-1) and 5 with moderate (GOLD-2) COPD. In airways from control lungs fibroblasts make frequent contact with cytoplasmic extensions of epithelial cells through apertures in the epithelial basal lamina, but the frequency of these fibroblast-epithelial contacts is reduced in both mild and moderate COPD compared to controls (p < 0.01). The 3D reconstructions showed that the cytoplasmic extensions of lamina propria fibroblasts form a reticulum with fibroblast-fibroblast contacts in an airway from a control subject but this reticulum may be reorganized in airways of COPD patients. Development of COPD is associated with significant disruption of the EMTU due to a reduction of contacts between fibroblasts and the epithelium.
COPD 的进展与小气道壁厚度的可测量增加有关，这是由于涉及上皮间充质营养单位（EMTU）的成纤维细胞的修复和重塑过程。本研究旨在检查 COPD 患者小气道固有层中成纤维细胞的组织，以了解它们与上皮的接触以及彼此之间的接触。使用透射电子显微镜（TEM）和 TEM 切片的三维（3D）重建来估计 EMTU 中小气道上皮和成纤维细胞之间的接触频率，并确定其性质。从 5 名对照者（吸烟但肺功能正常者）、6 名轻度（GOLD-1）和 5 名中度（GOLD-2）COPD 患者的小气道中获取。在对照肺的气道中，成纤维细胞通过上皮基膜中的孔频繁接触上皮细胞的细胞质延伸，但与对照者相比，轻度和中度 COPD 中这些成纤维细胞-上皮接触的频率降低（p<0.01）。3D 重建显示，固有层成纤维细胞的细胞质延伸在对照者的气道中形成一个与成纤维细胞-成纤维细胞接触的网状结构，但在 COPD 患者的气道中，该网状结构可能会重新组织。COPD 的发展与 EMTU 的显著破坏有关，这是由于成纤维细胞和上皮之间的接触减少所致。
