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Airway dimensions in fatal asthma and fatal COPD: overlap in older patients.
COPD. 2013 Jun; 10(3):348-56.COPD

Abstract

In some patients with chronic asthma clinical and physiological similarities with COPD may exist, such as partial reversibility to bronchodilators and persistent expiratory airflow obstruction. However, pathological data comparing both diseases in patients of similar age and disease severity are scarce. We compared large and small airway dimensions in 12 younger (mean age 32 yrs) and 15 older (mean age 65 yrs) non-smoker adult fatal asthma patients with 14 chronic smokers with severe, fatal COPD (mean age 71 yrs). Using H&E, Movat pentachrome staining and image analysis, we quantified large airway basement membrane (BM) thickness (μm), submucosal gland area and large and small airway inner wall, smooth muscle and outer wall areas. Areas were normalized by BM perimeter (μm(2)/μm). Younger adult fatal asthma patients had thicker BM, smooth muscle, and outer wall areas in both small and large airways when compared to COPD patients. In older asthmatics there was an overlap in BM thickness and airway structure in small airways. Inner wall layer in large and small airway level and submucosal gland areas were similar among groups. In conclusion, there are airway histological structural similarities between fatal asthma and fatal COPD. Older fatal asthmatics present overlapping airway structural features with younger adult fatal asthmatics and severe COPD patients. Our data contributes to a better understanding of asthma pathology in the elderly.

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Publisher Full Text

Authors+Show Affiliations

Senhorini A
Department of Pathology, School of Medicine, Sao Paulo University, Sao Paulo, Brazil.
Ferreira DS
No affiliation info available
Shiang C
No affiliation info available
Silva LF
No affiliation info available
Dolhnikoff M
No affiliation info available
Gelb AF
No affiliation info available
Mauad T
No affiliation info available

MeSH

AdultAgedAirway RemodelingAsthmaBasement MembraneCase-Control StudiesDeathHumansMiddle AgedMuscle, SmoothPulmonary Disease, Chronic ObstructiveRespiratory SystemSeverity of Illness IndexSmoking

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23537051

Clinical Trial Links

Mechanism(s) of Airflow Limitation During Exacerbation of Asthma

Citation

Senhorini, Aletéa, et al. "Airway Dimensions in Fatal Asthma and Fatal COPD: Overlap in Older Patients." COPD, vol. 10, no. 3, 2013, pp. 348-56.
Senhorini A, Ferreira DS, Shiang C, et al. Airway dimensions in fatal asthma and fatal COPD: overlap in older patients. COPD. 2013;10(3):348-56.
Senhorini, A., Ferreira, D. S., Shiang, C., Silva, L. F., Dolhnikoff, M., Gelb, A. F., & Mauad, T. (2013). Airway dimensions in fatal asthma and fatal COPD: overlap in older patients. COPD, 10(3), 348-56. https://doi.org/10.3109/15412555.2012.752806
Senhorini A, et al. Airway Dimensions in Fatal Asthma and Fatal COPD: Overlap in Older Patients. COPD. 2013;10(3):348-56. PubMed PMID: 23537051.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Airway dimensions in fatal asthma and fatal COPD: overlap in older patients. AU - Senhorini,Aletéa, AU - Ferreira,Diogenes S, AU - Shiang,Christina, AU - Silva,Luiz F F, AU - Dolhnikoff,Marisa, AU - Gelb,Arthur F, AU - Mauad,Thais, Y1 - 2013/03/28/ PY - 2013/3/30/entrez PY - 2013/3/30/pubmed PY - 2014/2/25/medline SP - 348 EP - 56 JF - COPD JO - COPD VL - 10 IS - 3 N2 - In some patients with chronic asthma clinical and physiological similarities with COPD may exist, such as partial reversibility to bronchodilators and persistent expiratory airflow obstruction. However, pathological data comparing both diseases in patients of similar age and disease severity are scarce. We compared large and small airway dimensions in 12 younger (mean age 32 yrs) and 15 older (mean age 65 yrs) non-smoker adult fatal asthma patients with 14 chronic smokers with severe, fatal COPD (mean age 71 yrs). Using H&E, Movat pentachrome staining and image analysis, we quantified large airway basement membrane (BM) thickness (μm), submucosal gland area and large and small airway inner wall, smooth muscle and outer wall areas. Areas were normalized by BM perimeter (μm(2)/μm). Younger adult fatal asthma patients had thicker BM, smooth muscle, and outer wall areas in both small and large airways when compared to COPD patients. In older asthmatics there was an overlap in BM thickness and airway structure in small airways. Inner wall layer in large and small airway level and submucosal gland areas were similar among groups. In conclusion, there are airway histological structural similarities between fatal asthma and fatal COPD. Older fatal asthmatics present overlapping airway structural features with younger adult fatal asthmatics and severe COPD patients. Our data contributes to a better understanding of asthma pathology in the elderly. SN - 1541-2563 UR - https://www.unboundmedicine.com/medline/citation/23537051/Airway_dimensions_in_fatal_asthma_and_fatal_COPD:_overlap_in_older_patients_ L2 - https://www.tandfonline.com/doi/full/10.3109/15412555.2012.752806 DB - PRIME DP - Unbound Medicine ER -