Morphometric characteristics of the bronchial tree in smokers with and without chronic obstructive pulmonary disease

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Aim. To reveal the tissue, cellular, and molecular predictors leading to the development of chronic obstructive pulmonary disease (COPD) in smokers on the basis of a morphometric analysis of bronchial biopsy specimens. Subjects and methods. A cross-sectional study was conducted in 115 smokers aged 40 to 60 years (58.3±3.24 years) with a male predominance of 90.9%. Morphological examination of bronchial biopsy specimens was first made in the smoking patients with and without COPD. Results. The smokers with COPD versus those without this condition were found to have a statistically significant increase in a number of indicators: the specific volume (SV) of the surface epithelium (p=0.017), SV of basal epitheliocytes (p=0.008), the height of the epithelium (p=0.001), and the thickness of the basal membrane (p=0.006) due to impaired regeneration processes in the bronchial epithelium and to fibrosis of the lamina propria of the bronchi with a concurrent increase in the total number of fibroblasts. The group of smokers with COPD, unlike the comparison group, showed signs of vascular remodeling and microcirculatory disorders as the increased connective tissue volumetric density of the lamina propria of the bronchi with predominant perivascular localization. This was followed by reductions in the relative volume of capillaries (p=0.016), in the SV of micropinocytic vesicles (p=0.005), and the size of Weibel-Palade bodies (p=0.004) in the endotheliocytes. In the COPD patients, the total density of cell infiltrate per mm2 of the lamina propria of the bronchi was statistically significantly (p<0.001) greater than that in the comparison group at the expense of neutrophils, lowly and moderately granulated basophils, macrophages, plasma cells with a simultaneous rise in their interepithelial forms. Conclusion. Compensatory structural changes without signs of bronchial wall remodeling were recorded in the smokers without signs of bronchial disease. The smokers with the examined nosological entity were observed to have morphological signs of hemodynamic disorders, as well as perivascular fibrosis, atrophy, and squamous cell metaplasia of the bronchial epithelial lining.

About the authors

I S Kremis

E B Bukreeva

E A Gereng


  1. Черняев А.Л., Самсонова М.В. Варианты хронической обструктивной болезни легких с позиции патологоанатома. Пульмонология. 2013;3:93-96.
  2. Геренг Е.А., Суходоло И.В., Плешко Р.И., Огородова Л.М., Букреева Е.Б., Селиванова П.А., Дзюман А.Н., Кремис И.В., Еремина Т.А. Сравнительная ультраструктурная характеристика слизистой оболочки бронхов при различных типах воспаления дыхательных путей. Вестник Волгоградского Государственного медицинского университета. 2011;1(37):70-73.
  3. Цветкова О.А., Мустафина М.Х. Полиморфизм гена ADRВ2: роль в предрасположенности к заболеванию, тяжести течения и терапевтическом ответе при хронической обструктивной болезни легких. Пульмонология. 2013;2:5-9.
  4. Кадушкин А.Г., Таганович А.Д., Картун Л.В., Ходосовская Е.В., Чупик В.Н. Уровень цитокинов в плазме крови некурящих и курящих пациентов с хронической обструктивной болезнью легких. Пульмонология. 2013;(6):27-32.
  5. Kosciuch J, Krenke R, Gorska K, Baran W, Kujawa M, Hildebrand K and Chazan R. Comparison of airway wall remodeling in asthma and COPD: biopsy findings. Respiratory Care. 2012;57(4):557-564. doi: 10.4187/respcare.01359.
  6. Кузубова Н.А., Лебедева Е.С., Золотницкая В.П., Двораковская И.В., Федин А.Н., Титова О.Н. Сосудистые нарушения в легких при хронической обструктивной болезни легких как мишень для терапевтического воздействия. Пульмонология. 2012;4:71-77.
  7. Непомнящих Г.И. Биопсия бронхов: морфогенез общепатологических процессов в легких. М.: Издательство РАМН; 2010.
  8. Hogg JC, Timens W. The pathology of chronic obstructive pulmonary disease. Annu Rev Pathol. 2009;4:435-459. doi: 10.1146/annurev.pathol.4.110807.092145.
  9. Puchelle E, Zahm J, Tournier J. and Coraux C. Airway Epithelial Repair, Regeneration, and Remodeling after Injury in Chronic Obstructive Pulmonary Disease. Proceed Am Thoracic Society. 2006;3(8):726-733. doi: 10.1513/pats.200605-126sf.
  10. Lapperre T, Sont J, van Schadewijk A, Gosman M, Postma D, Bajema I, Timens W, Mauad T, Hiemstra P. and Study Group T. Smoking cessation and bronchial epithelial remodelling in COPD: a cross-sectional study. Respiratory Res. 2007;8(1):85. doi: 10.1186/1465-9921-8-85.
  11. Kosciuch J, Krenke R, Gorska K et al. Comparison of Airway Wall Remodeling in Asthma and Chronic Obstructive Pulmonary Disease. Biopsy Findings. Respiratory Care. 2012;57(4):557-564. doi: 10.4187/respcare.01359.
  12. Köktürk N, Tatlicioğlu T, Memiş L, Türkkani G. The cellular inflammation оf bronchial biopsies in chronic obstructive pulmonary diseases. Tuberk Toraks. 2003;51(2):123-131.
  13. Soltani A, Reid D, Sohal S et al. Basement membrane and vascular remodelling in smokers and chronic obstructive pulmonary disease: a cross-sectional study. Respir Res. 2010;11(1):105. doi: 10.1186/1465-9921-11-105.
  14. Rodella L, Favero G, Rossini C, Foglio E, Reiter R, Rezzani R. Endothelin-1 as a potential marker of melatonin’s therapeutic effects in smoking-induced vasculopathy. Life Scie. 2010;87(17-18):558-564. doi: 10.1016/j.lfs.2010.09.011.
  15. Kubo H, Takahashi T. The role of microparticles in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2014:303. doi: 10.2147/copd.s38931.
  16. D’Armiento J, Scharf S, Roth M et al. Eosinophil and T cell markers predict functional decline in COPD patients. Respir Res. 2009;10(1):113. doi: 10.1186/1465-9921-10-113.
  17. Willemse B. Effect of 1-year smoking cessation on airway inflammation in COPD and asymptomatic smokers. Eur Respir J. 2005;26(5):835-845. doi: 10.1183/09031936.05.00108904.
  18. Lapperre TS, Willems LN, Timens W et al. Small Airways Dysfunction and Neutrophilic Inflammation in Bronchial Biopsies and BAL in COPD. Chest. 2007;131(1):53-59. doi: 10.1378/chest.06-0796.
  19. Blidberg K, Palmberg L, James A et al. Adhesion molecules in subjects with COPD and healthy non-smokers: a cross sectional parallel group study. Respir Res. 2013;14(1):47. doi: 10.1186/1465-9921-14-47.
  20. Willemse B, ten Hacken N, Rutgers B, Postma D, Timens W. Association of current smoking with airway inflammation in chronic obstructive pulmonary disease and asymptomatic smokers. Respiratory Medicine: COPD Update. 2005;1(2):61-61. doi: 10.1016/j.rmedu.2005.09.009.
  21. Magno F, Di Stefano A. Contribution of bronchial biopsies in the evaluation of pathogenesis and progression of COPD. Monaldi Arch Chest Dis. 2007;67(4):229-233.
  22. Di Stefano A, Caramori G, Ricciardolo F, Capelli A, Adcock I, Donner C. Cellular and molecular mechanisms in chronic obstructive pulmonary disease: an overview. Clin Exp Allergy. 2004;34(8):1156-1167. doi: 10.1111/j.1365-2222.2004.02030.x.
  23. Gosman M. Increased number of B-cells in bronchial biopsies in COPD. Eur Respir J. 2006;27(1):60-64. doi: 10.1183/09031936.06.00007005.
  24. Ekberg-Jansson A, Amin K, Bake B et al. Bronchial mucosal mast cells in asymptomatic smokers relation to structure, lung function and emphysema. Respir Med. 2005;99(1):75-83. doi: 10.1016/j.rmed.2004.05.013.
  25. Soltani A, Ewe Y, Lim Z et al. Mast cells in COPD airways: relationship to bronchodilator responsiveness and angiogenesis. Eur Respir J. 2011;39(6):1361-1367. doi: 10.1183/09031936.00084411.
  26. Mortaz E, Folkerts G, Redegeld F. Mast cells and COPD. Pulmon Pharmacol Ther. 2011;24(4):367-372. doi: 10.1016/j.pupt.2011.03.007.
  27. Букреева Е.Б., Сеитова Г.Н., Кремис И.С., Пузырёв В.П. Ассоциация полиморфных вариантов генов цитокинов TNF и ИЛ-8 с развитием хронической обструктивной болезни легких. Бюллетень Сибирской медицины. 2010;9(3):91-97.
  28. Букреева Е.Б., Сеитова Г.Н., Кремис И.С., Пузырёв В.П. Анализ взаимосвязи полиморфизмов генов TNF и ИЛ-8 с формированием клинических особенностей хронической обструктивной болезни легких. Бюллетень Сибирской медицины. 2010;9(5):88-92.
  29. Eltboli O, Bafadhel M, Hollins F et al. COPD exacerbation severity and frequency is associated with impaired macrophage efferocytosis of eosinophils. BMC Pulmon Med. 2014;14(1):112. doi: 10.1186/1471-2466-14-112.
  30. Черногорюк Г.Э. и др. Активация антипротеиназ в бронхиальном регионе — фактор толерантности формирования хронической обструктивной болезни лёгких у здоровых злостных курильщиков. Бюллетень СО РАМН. 2010;30(3):124-129.

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