Small Airway Remodeling in Idiopathic Interstitial Pneumonias: A Pathological Study

George Castro Figueira de Mello, Carlos Roberto Ribeiro Carvalho, Ronaldo Adib Kairalla, Paulo Hilário Nascimento Saldiva, Sandra Fernezlian, Luiz Fernando Ferraz Silva, Marisa Dolhnikoff, Thais Mauad
2010 Respiration  
creased epithelial areas, whereas patients with CB had larger inner wall areas. All of the groups studied presented increased bronchiolar expression of MMP-7 and MMP-9, compared to the controls. Conclusion: We conclude that SAs are pathologically altered and may take part in the lung-remodeling process in idiopathic interstitial pneumonias. Abstract Background: Few studies have addressed small airway (SA) histopathological changes and their possible role in the remodeling process in idiopathic
more » ... nterstitial pneumonias. Objectives: To study morphological, morphometrical and immunohistochemical features of SA in idiopathic pulmonary fibrosis (usual interstitial pneumonia, UIP) and nonspecific interstitial pneumonia (NSIP). Methods: We analyzed SA pathology in lung biopsies from 29 patients with UIP and 8 with NSIP. Biopsies were compared with lung tissue from 13 patients with constrictive bronchiolitis (CB) as positive controls and 10 normal autopsied control lungs. We semi-quantitatively analyzed SA structure, inflammation, architectural features and the bronchiolar epithelial immunohistochemical expression of TGF-␤ , MMP-2, 7, 9, and their tissue inhibitors (TIMP-1, 2). Results: Compared to controls, patients with UIP, NSIP and CB presented increased bronchiolar inflammation, peribronchiolar inflammation and fibrosis and decreased luminal areas. UIP patients had thicker walls due to an increase in most airway compartments. NSIP patients presented in-
doi:10.1159/000235722 pmid:19690403 fatcat:imi3om5i7naknfhacudc5yxp3q