Cardoso W V, Sekhon H S, Hyde D M, Thurlbeck W M
Department of Pathology, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Am Rev Respir Dis. 1993 Apr;147(4):975-81. doi: 10.1164/ajrccm/147.4.975.
Studies of collagen and elastin in pulmonary emphysema have been controversial. The problems involve methodologic differences; often whole lungs have been sampled and the types of emphysema have not been classified. Quantification of collagen and elastin is important since the increase in collagen supports the inflammatory-repair hypothesis of emphysema, which has been recently revived. On the other hand, loss of elastin supports the protease-antiprotease hypothesis. Accordingly, we measured collagen (hydroxy-proline) and elastin (desmosine) in 147 small samples of human lungs removed for cancer. The amount and type of collagen were also assessed histochemically in tissue blocks adjacent to the tissue used for the biochemical analysis. We found that collagen in the homogenates was increased only in irregular airspace enlargement, but histochemically, collagen was consistently increased in centriacinar, distal acinar, and irregular air-space enlargement sections. Elastin was decreased in all grades of panacinar air-space enlargement and also in severe centriacinar air-space enlargement. Our data support both the protease-antiprotease imbalance hypothesis in panacinar and the inflammatory-repair hypothesis in centriacinar, distal acinar, and irregular air-space enlargement.
关于肺气肿中胶原蛋白和弹性蛋白的研究一直存在争议。问题涉及方法学差异；通常对整个肺进行采样，且未对肺气肿的类型进行分类。胶原蛋白和弹性蛋白的定量很重要，因为胶原蛋白的增加支持了最近重新兴起的肺气肿炎症修复假说。另一方面，弹性蛋白的减少支持蛋白酶 - 抗蛋白酶假说。因此，我们对147个因癌症切除的人肺小样本中的胶原蛋白（羟脯氨酸）和弹性蛋白（锁链素）进行了测量。还在用于生化分析的组织相邻的组织块中通过组织化学方法评估了胶原蛋白的含量和类型。我们发现，匀浆中的胶原蛋白仅在不规则气腔扩大中增加，但在组织化学上，在小叶中心型、远端腺泡型和不规则气腔扩大切片中胶原蛋白持续增加。在全腺泡型气腔扩大的所有级别以及严重的小叶中心型气腔扩大中弹性蛋白均减少。我们的数据支持全腺泡型中的蛋白酶 - 抗蛋白酶失衡假说以及小叶中心型、远端腺泡型和不规则气腔扩大中的炎症修复假说。
