Leyla MEMİŞ, Gülten TÜRKKANI, Türkan TATLICIOĞLU, Nurdan KÖKTÜRK

The cellular inflammation of bronchial biopsies in chronic obstructive pulmonary diseases (A comparison with asthma)

Bu çalışmada kronik obstrüktif akciğer hastalığı (KOAH) hastalarından elde edilen bronş biyopsi örneklerinde hücresel infiltrasyonun belirlenmesi, yapısal değişikliklere ait patolojik bulguların tanımlanması ve bu bulguların astım hastaları ile karşılaştırılması amaçlanmıştır. Çalışmaya yaş ortalaması 49 ± 15 olan 15'i kadın, 20'si erkek olmak üzere; 13'ü KOAH, 12'si astım ve 10'u sağlıklı kontrol grubunda olan toplam 35 olgu dahil edildi. Alınan bronş biyopsi örneklerinde hematoksilen eozin boyası ile elde edilen kesitlerde inflamatuuar hücre sayıları, bazal membran kalınlığı (BMK) ve epitelyal deskuamasyon (ED) değerlendirildi. KOAH grubunda nötrofil düzeyleri diğer gruplardan istatistiksel olarak anlamlı düzeyde yüksek saptanırken, astım grubunda eozinofil düzeyleri yüksek olarak bulundu (p< 0.001, p< 0.05). BMK, KOAH grubunda 13 olgunun altısında saptanmışken, astımlı olguların biri hariç hepsinde görüldü. Kontrol grubunda yalnızca bir olguda BMK saptandı. ED, KOAH grubunda yalnızca iki olguda saptanırken, astım grubunda 12 olgunun 11'inde mevcuttu. Kontrol grubunda ise hiçbir olguda saptanmadı. Bu verilere dayanarak KOAH'ta bronş mukozasında nötrofillerin, astımda ise eozinofilerin predominant hücreler olduğu, bazal membran kalınlığındaki artış ve epitelyal deskuamasyonun astımda karakteristik olarak saptandığı, bulgulardaki belirgin farklılıklar nedeniyle bronş biyopsi örneklemesinin astım ve KOAH ayırıcı tanısında faydalı bir metod olabileceği ortaya konmuştur.

Kronik obstrüktif akciğer hastalığında bronş biyopsi örneklerinde hücresel inflamasyon (Bronş astımı ile karşılaştırmalı)

This study was designed to describe the cellular inflammation, thickness of basement membrane (BMT) and epithelial desquamation (ED) in bronchial biopsies from patients with chronic obstructive pulmonary disease (COPD) compared with asthma and healthy individuals. Thirteen subjects with COPD, 12 asthmatic subjects, and 10 healthy indiuiduals enrolled in the study. Bronchial biopsies obtained by fiberoptic bronchoscopy were stained with hemaloxylin and eosin to perform cell counts and descriptive analysis, fieutrophils were found in higher numbers in epithelium and lamina propria in subjects with COPD compared with asthma and control groups (p< 0.001, p< 0.05) whereas eosinophils were observed higher in epithelium and lamina propria in asthmatic subjects (p< 0.001, p< 0.001). There were no significant differences in num-bers of neutrophils and eosinophils in submucosa in the three groups (p> 0.05). There were no significant correlations between the inflammatory cell counts and FEVj or smoking history in either group (p> 0.05). In subjects with COPD only 6 (46.2%) of the subjects showed BMT whilst 2 (15.4%) of the subjects showed ED. In asthma group, 11 (91.7%) of the subjects presented increased BMT and ED. In healthy individuals 1 (10%) of the subjects had increased BMT and no one had ED. As a result, we may conclude that the predominant cells of bronchial mucosa in COPD are the neutrophils whereas they are eosinophils in asthma. Thickening of basement membrane and epithelial desquamation are the major features of asthmatics. However in COPD, these features would be focally present and variable.

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