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. 2021 Apr 7;76(11):1079–1088. doi: 10.1136/thoraxjnl-2020-216037

Figure 1.

Figure 1

Epithelial remodelling and mucus accumulation in small airways of patients with COPD. (A) Representative images of normal-appearing structural organisation of small airway in lifelong NS subject and a combination of goblet cell metaplasia and increased epithelial height in small airway from a patient in GOLD stage IV COPD. PAS staining. Scale bars=100 µm. Inserts show detailed characteristics of epithelial remodelling. (B, C) Box and whisker plots showing progressive increase of epithelial height (V:SAepi) (B) and reduction of airway luminal area due to epithelial expansion (C) in COPD small airways compared with NS and FS airways. (D) Mucus plug in the airway lumen. PAS staining. Scale bar=100 µm. (E) Box and whisker plots showing progressive reduction of airway luminal area due to mucus plugging in COPD small airways compared with NS and FS airways. Boxes represent the IQR, whiskers extend to the most extreme data point which is no more than 1.5 times the IQR from the box, and circles beyond the whiskers are extreme values, the line within the box represents the median. Groups were compared pairwise using Mann-Whitney U test. Estimated p values were Bonferroni-adjusted. The threshold for significance was 0.05. *Significantly different compared with NS controls, **significantly different compared with all other groups. FS, former smoker; GOLD, Global Initiative for Chronic Obstructive Lung Disease; NS, non-smoker; PAS, periodic acid-Schiff.