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. 2001 Dec;56(12):902–906. doi: 10.1136/thorax.56.12.902

Quantitative and morphological analysis of the vascular bed in bronchial biopsy specimens from asthmatic and non-asthmatic subjects

G Salvato 1
PMCID: PMC1745985  PMID: 11713351

Abstract

BACKGROUND—This study was designed to establish the number and area (as a percentage) of bronchial wall vessels in subjects with and without asthma, to obtain information on the morphology of the vessels, and to see whether changes differed in patients with mild, moderate, and severe asthma.
METHODS—Biopsy specimens were taken using a rigid bronchoscope from the carina of the middle lobe bronchus of 20 patients with allergic asthma and 20 non-asthmatic controls. Specimens were sectioned and stained with haematoxylin-eosin, Masson trichrome, PAS, alcian blue-PAS, and orcein. The vessels were counted and the vascular area was calculated as a percentage in the lamina propria, in blind conditions, on PAS stained sections in 50 microscopic fields (magnification ×1000, 0.02 mm2 per field). The vascular area was calculated using the points counting procedure (Chalkley point array). The vascular morphology, intravascular cells, and the perivascular area were also studied using a magnification up to ×1200.
RESULTS—Patients with asthma had more vessels (mean (SD) 226.70 (74.53) v 172.05 (30.58), p=0.0043) and a larger percentage vascular area (8.61 (2.38)% v 6.81 (2.25)%, p=0.028) than non-asthmatic subjects. Patients with severe asthma had significantly more vessels than those with mild or moderate disease (p=0.0044). Asthmatic capillaries and venules had oedematous walls and thickening of the subendothelial basement membrane, and hypotrophic or atrophic myocytes and fibrosis in the arterioles. Vessels from asthmatic subjects showed eosinophil recruitment, activation, and intravascular lysis. Intense eosinophil recruitment was associated with more marked vascular structural changes. Muscular formations protruded into the lumen in the arterioles of both groups, and in asthmatics these had hypotrophic or atrophic myocytes and fibrosis.
CONCLUSIONS—Morphometric analysis showed that the bronchial lamina propria of asthmatic subjects had a larger number of vessels, occupying a larger percentage area than in non-asthmatic subjects. The number of vessels was correlated with the severity of the asthma. Marked alterations to the vascular structure appeared to be associated with intense eosinophil recruitment and intravascular activation. This is the first report of asthmatic and non-asthmatic bronchial wall specimens containing intra-arteriolar muscular formations, presumably to regulate blood flow to the capillary network and/or sinusoids. This function might be impaired when these structures are remodelled in asthmatic patients.



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Selected References

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  1. Beasley R., Roche W. R., Roberts J. A., Holgate S. T. Cellular events in the bronchi in mild asthma and after bronchial provocation. Am Rev Respir Dis. 1989 Mar;139(3):806–817. doi: 10.1164/ajrccm/139.3.806. [DOI] [PubMed] [Google Scholar]
  2. Boucher R. C., Gilbert I. A., Hogg J. C., King M., Knowles M. R., Nadel J. Nonmuscular airway obstruction and asthma. Am J Respir Crit Care Med. 1995 Jul;152(1):408–410. doi: 10.1164/ajrccm.152.1.7599857. [DOI] [PubMed] [Google Scholar]
  3. Carroll N. G., Cooke C., James A. L. Bronchial blood vessel dimensions in asthma. Am J Respir Crit Care Med. 1997 Feb;155(2):689–695. doi: 10.1164/ajrccm.155.2.9032214. [DOI] [PubMed] [Google Scholar]
  4. DUNNILL M. S. The pathology of asthma, with special reference to changes in the bronchial mucosa. J Clin Pathol. 1960 Jan;13:27–33. doi: 10.1136/jcp.13.1.27. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Erjefält J. S., Greiff L., Andersson M., Matsson E., Petersen H., Linden M., Ansari T., Jeffery P. K., Persson C. G. Allergen-induced eosinophil cytolysis is a primary mechanism for granule protein release in human upper airways. Am J Respir Crit Care Med. 1999 Jul;160(1):304–312. doi: 10.1164/ajrccm.160.1.9809048. [DOI] [PubMed] [Google Scholar]
  6. James A. L., Paré P. D., Hogg J. C. The mechanics of airway narrowing in asthma. Am Rev Respir Dis. 1989 Jan;139(1):242–246. doi: 10.1164/ajrccm/139.1.242. [DOI] [PubMed] [Google Scholar]
  7. Kuwano K., Bosken C. H., Paré P. D., Bai T. R., Wiggs B. R., Hogg J. C. Small airways dimensions in asthma and in chronic obstructive pulmonary disease. Am Rev Respir Dis. 1993 Nov;148(5):1220–1225. doi: 10.1164/ajrccm/148.5.1220. [DOI] [PubMed] [Google Scholar]
  8. Li X., Wilson J. W. Increased vascularity of the bronchial mucosa in mild asthma. Am J Respir Crit Care Med. 1997 Jul;156(1):229–233. doi: 10.1164/ajrccm.156.1.9607066. [DOI] [PubMed] [Google Scholar]
  9. MOFFAT D. B. A regulatory mechanism in the posterior ciliary arteries of the dog. Nature. 1952 Jun 14;169(4311):1015–1016. doi: 10.1038/1691015a0. [DOI] [PubMed] [Google Scholar]
  10. Orsida B. E., Li X., Hickey B., Thien F., Wilson J. W., Walters E. H. Vascularity in asthmatic airways: relation to inhaled steroid dose. Thorax. 1999 Apr;54(4):289–295. doi: 10.1136/thx.54.4.289. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Persson C. G., Erjefält J. S. "Ultimate activation" of eosinophils in vivo: lysis and release of clusters of free eosinophil granules (Cfegs). Thorax. 1997 Jun;52(6):569–574. doi: 10.1136/thx.52.6.569. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Salvato G. Some histological changes in chronic bronchitis and asthma. Thorax. 1968 Mar;23(2):168–172. doi: 10.1136/thx.23.2.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Venge P. Serum measurements of eosinophil cationic protein (ECP) in bronchial asthma. Clin Exp Allergy. 1993 Jun;23 (Suppl 2):3-7, discussion 15-22. doi: 10.1111/j.1365-2222.1993.tb00372.x. [DOI] [PubMed] [Google Scholar]
  14. Widdicombe J. G. Asthma. Tracheobronchial vasculature. Br Med Bull. 1992 Jan;48(1):108–119. doi: 10.1093/oxfordjournals.bmb.a072528. [DOI] [PubMed] [Google Scholar]

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