Department of Physiology, University of Tennessee Health Science Center , Memphis, Tennessee.
Department of Medicine, University of Tennessee Health Science Center , Memphis, Tennessee.
Am J Physiol Lung Cell Mol Physiol. 2019 Jul 1;317(1):L39-L48. doi: 10.1152/ajplung.00050.2019. Epub 2019 Apr 24.
Airway narrowing due to hyperresponsiveness severely limits gas exchange in patients with asthma. Imaging studies in humans and animals have shown that bronchoconstriction causes patchy patterns of ventilation defects throughout the lungs, and several computational models have predicted that these regions are due to constriction of smaller airways. However, these imaging approaches are often limited in their ability to capture dynamic changes in small airways, and the patterns of constriction are heterogeneous. To directly investigate regional variations in airway narrowing and the response to deep inspirations (DIs), we utilized tantalum dust and microfocal X-ray imaging of rat lungs to obtain dynamic images of airways in an intact animal model. Airway resistance was simultaneously measured using the flexiVent system. Custom-developed software was used to track changes in airway diameters up to (~0.3-3 mm). Changes in diameter during bronchoconstriction were then measured in response to methacholine (MCh) challenge. In contrast with the model predictions, we observed significantly greater percent constriction in larger airways in response to MCh challenge. Although there was a dose-dependent increase in total respiratory resistance with MCh, the percent change in airway diameters was similar for increasing doses. A single DI following MCh caused a significant reduction in resistance but did not cause a significant increase in airway diameters. Multiple DIs did, however, cause significant increases in airway diameters. These measurements allowed us to directly quantify dynamic changes in airways during bronchoconstriction and demonstrated greater constriction in larger airways.
气道高反应导致的气道狭窄严重限制了哮喘患者的气体交换。人体和动物的影像学研究表明,支气管收缩会导致肺部通气缺陷呈斑片状分布,并且几个计算模型预测这些区域是由于较小气道的收缩。然而,这些成像方法通常在捕捉小气道的动态变化方面能力有限,并且收缩模式具有异质性。为了直接研究气道狭窄的区域变化和对深吸气(DIs)的反应,我们利用钽尘和大鼠肺部的微焦点 X 射线成像,在完整的动物模型中获得气道的动态图像。同时使用 flexiVent 系统测量气道阻力。定制的软件用于跟踪气道直径的变化,最大可达 (~0.3-3 毫米)。然后测量在乙酰甲胆碱(MCh)挑战下支气管收缩时的直径变化。与模型预测相反,我们观察到在 MCh 挑战下,较大气道的收缩程度明显更大。尽管 MCh 会导致总呼吸阻力呈剂量依赖性增加,但气道直径的变化百分比对于增加的剂量是相似的。MCh 后进行单次 DI 会显著降低阻力,但不会显著增加气道直径。然而,多次 DI 确实会导致气道直径显著增加。这些测量允许我们直接量化支气管收缩期间气道的动态变化,并证明较大气道的收缩程度更大。