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Cellular and connective tissue changes in alveolar septal walls in emphysema.

Authors
Vlahovic-G; Russell-ML; Mercer-RR; Crapo-JD
Source
Am J Respir Crit Care Med 1999 Dec; 160(6):2086-2092
NIOSHTIC No.
20025375
Abstract
Emphysema is commonly defined as enlargement of airspaces distal to terminal bronchioles accompanied by destruction of alveolar walls, but without obvious fibrosis. Morphometric techniques were used to correlate changes in components of the alveolar septa surrounding enlarged airspaces in human emphysema with the mean linear intercept (Lm) of those airspaces. Alveolar and capillary surface density decreased with increased Lm, but the ratio of these surface densities to each other remained close to normal for mild to moderate increases in Lm. This suggests that the decreased gas exchange observed in emphysema is initiated by a total loss of septa and not by selective pathological changes of the microvasculature. Increases in septal wall thickness directly correlated with increases in Lm. For the mild to moderate emphysema lesions included in this study, an increase of 100% in Lm correlated with a 130% increase in the relative volume of the alveolar septal interstitium. Significant increases occurred in both elastin (0.14 to 0.56 microm(3)/microm(2) basement membrane [BM]) and collagen (0.49 to 1. 63 microm(3)/microm(2) BM). The increase in elastin and collagen raises the possibility of a remodeling process in the connective matrix in alveolar walls. Whether or not the new connective tissue represents a disordered, nonfunctional regional response needs to be determined.
Keywords
Alveolar-cells; Lung-disorders; Respiratory-system-disorders; Pulmonary-system-disorders; Lung-tissue; Chronic-degenerative-diseases
Contact
James D. Crapo, M.D., National Jewish Medical and Research Center, 1400 Jackson Street, Denver, CO 80206
CODEN
AJCMED
Publication Date
19991201
Document Type
Journal Article
Email Address
CRAPOJ@njc.org
Fiscal Year
2000
NTIS Accession No.
NTIS Price
Issue of Publication
6
ISSN
1073-449X
NIOSH Division
HELD
Source Name
American Journal of Respiratory and Critical Care Medicine
State
WV; NC; CO
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