In vivo endomicroscopic features of distal airways in chronic bronchitis and chronic obstructive pulmonary disease

Abstract

Relevance: Probe-based confocal laser endomicroscopy (CLE) of distal airways is a unique technology that allows real-time visualization of structures containing natural fluorophores, which are emitted by exposure to laser radiation with a wavelength of 488 nm, in vivo. To date, the endomicroscopic features of the distal respiratory tract have not been adequately studied in lung diseases, including chronic obstructive pulmonary disease and chronic bronchitis.
 The goal of the present study is to describe the endomicroscopic signs of the distal parts of the respiratory system in chronic inflammatory lung diseases such as chronic obstructive pulmonary disease and chronic bronchitis.
 Methods: A total of 21 patients with emphysematous and bronchitic phenotypes of chronic obstructive pulmonary disease and chronic bronchitis were examined. All the patients have undergone CLE of distal airways or alveoloscopy during bronchoscopy. The most pathognomonic changes were evaluated on the obtained endomicroscopic images.
 Results: For each studied nosological form of chronic inflammatory lung diseases, by careful morphometric analysis of a significant number of informative images, the most specific endomicroscopic changes were identified with the release of CLE patterns.
 Conclusions: CLE of distal airways in patients with chronic inflammatory lung diseases allows visualizing changes in the elastic framework of the acini, as well as identifying pathological intraluminal contents, which can be attributed to valuable additional tools in a row of diagnostic methods of respiratory medicine.