Abstract

Extensive evidence indicates that several types of temperature-sensitive ion channels are abundantly expressed in the sensory nerves innervating airway mucosa. Indeed, airway temperature is known to play an important role in regulating respiratory functions. However, the actual airway mucosal temperature and its dynamic changes during the respiratory cycle have not been directly measured. In previous studies, airway tissue temperature was often estimated by indirect measurement of the peak exhaled breath temperature (PEBT). In view of the poor thermal conductivity of air, we believe that the airway tissue temperature cannot be accurately determined by the exhaled air temperature, and this study aimed to test this hypothesis. We applied a miniature rapid-response temperature probe to measure directly the mucosal temperatures of trachea, major, lobar, and segmental bronchi in eight human subjects during a bronchoscopy procedure. Unlike the air temperature in the airway lumen, the mucosal temperature in these airway segments remained relatively stable and did not exhibit the phasic changes synchronous with respiratory cycles. The airway mucosal temperature increased progressively from the extra-thoracic trachea (35.7 ± 0.2°C) toward the segmental bronchus (36.9 ± 0.2°C). Most importantly, the temperatures measured directly at the mucosa of all these airway segments were substantially higher than the PEBT (31.7 ± 0.8°C). The recent findings of a close association between an increased PEBT and airway tissue inflammation have revealed the implication and potential of incorporating the PEBT measurement in the future clinical diagnosis of airway inflammation. Therefore, it is imperative to recognize this distinct difference in temperature between airway mucosa and exhaled air.

Highlights

  • A change in airway temperature can cause profound changes in airway functions under both physiological and pathophysiological conditions

  • A deviation of airway tissue temperature from normal level may reflect a pathophysiological condition of the airways [3, 4], and it can lead to abnormal changes in airway functions [1, 2, 15, 17]

  • Because the lung and airways are enclosed in the thoracic chamber, it seems logical to assume that their tissue temperatures are constantly maintained at the body core temperature

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Summary

Introduction

A change in airway temperature can cause profound changes in airway functions under both physiological and pathophysiological conditions. Direct Measurement of Airway Mucosal Temperature induced by hyperventilation with warm humidified air triggered airway hypersensitivity and bronchoconstriction in anesthetized rats [5, 6]. The data of mucosal temperature recorded by a direct measurement in human airways is lacking because the procedure is difficult to perform in awake subjects. As such, in those previous studies the tissue temperature of intrathoracic airways was estimated by a measurement of the peak (endtidal) exhaled breath temperature [PEBT; [3, 4, 15,16,17]]. In view of the poor thermal conductivity of air [18], this study was designed to determine whether and to what extent these previously reported airway temperatures were underestimated by the indirect measurement of the exhaled air temperature

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