Mast Cell Infiltration Discriminates between Histopathological Phenotypes of Chronic Obstructive Pulmonary Disease

• DOI: 10.1164/rccm.201112-2142oc
• Publication Date: 2012-06-08T04:39:57Z
• Authors: Andrea Ballarin; Erica Bazzan; Rafael Hernandez ...; Graziella Turato; Simonetta Baraldo; Dora Zanovello; Elena Mutti; James C. Hogg; Marina Saetta; Manuel G. Cosio
• Keywords: Small airways; Infiltration (HVAC)

Rationale: COPD is a complex disease with heterogeneous manifestations. Attempts have been made to define different phenotypes that could guide toward better understanding. We described before smokers can develop either panlobular (PLE) or centrilobular emphysema (CLE). The latter has worse small airways remodeling and narrowing, which account for the airflow obstruction similar asthma.Objectives: Because of involvement in CLE asthma, we hypothesized role mast cells but not PLE. Hence, investigated cell infiltration, along overall inflammation, their relation hyperreactivity type COPD.Methods: studied lung function, type, cells, inflammation alveolar walls, wall thickening 67 subjects undergoing resection (59 smokers, 8 nonsmokers).Measurements Main Results: Twenty-seven had CLE, 24 PLE, no emphysema. Mast were significantly increased compared PLE control subjects. Especially relevant was increase airway smooth muscle related hyperreactivity. CD4+T neutrophils, macrophages, eosinophils CD8+T higher than Alveolar thickness all more CLE.Conclusions: pathological show important differences protagonism are reactivity. These findings highlight distinctness these pathophysiology COPD.