Abstract

BackgroundChronic obstructive pulmonary disease (COPD) is characterized by structural changes in alveoli and airways. Our aim was to analyse the numbers of alpha-smooth muscle actin (α-SMA) positive cells, as a marker of myofibroblasts, in different lung compartments in non-smokers and smokers with normal lung function or COPD.Methodsα-SMA, tenascin-C (Tn-C) and EDA-fibronectin in alveolar level and airways were assayed by immunohistochemistry and quantified by image analysis. Immunohistochemical findings were correlated with clinical data. α-SMA protein was also analysed by Western blotting from fibroblastic cells cultured from peripheral lung of non-smokers, smokers without COPD and smokers with COPD.ResultsIn many cases, the endings of the detached alveolar walls were widened, the structures of which were named as widened alveolar tips. Widened alveolar tips contained α-SMA positive cells, which were obviously myofibroblasts. There were less alveolar tips containing positive cells for α-SMA in alveoli and α-SMA positive cells in bronchioles in smokers and in COPD compared to non-smokers. The quantity of α-SMA positive cells was increased in bronchi in COPD. Tn-C was elevated in bronchi in COPD and smokers’ lung. The α-SMA protein level was 1.43-fold higher in stromal cells cultured from non-smokers than in those of smokers.ConclusionsMyofibroblasts are localized variably in normal and diseased lung. This indicates that they have roles in both regeneration of lung and pathogenesis of COPD. The widened alveolar tips, these newly characterized histological structures, seemed to be the source of myofibroblasts at the alveolar level.

Highlights

  • Chronic obstructive pulmonary disease (COPD) is characterized by structural changes in alveoli and airways

  • We named those structures as widened alveolar tips, and observed that they contained Alpha-smooth muscle actin (α-SMA) positive cells, which were obviously myofibroblasts and to a lesser extent mainly extracellular Tn-C and extra type III domain A – fibronectin (EDA-Fn) positivity, both in normal and diseased lung (Figure 1)

  • The smokers with normal lung function (p < 0.001, Dunnett t-test) and the individuals with COPD (p < 0.001, Dunnett t-test) exhibited a reduced number of α-SMA positive widened alveolar tips when compared to the nonsmokers

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Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is characterized by structural changes in alveoli and airways. Our aim was to analyse the numbers of alpha-smooth muscle actin (α-SMA) positive cells, as a marker of myofibroblasts, in different lung compartments in non-smokers and smokers with normal lung function or COPD. Chronic obstructive pulmonary disease (COPD) is characterized by the destruction of alveoli and fibrosis of airway walls, which lead to the enlargement of air spaces i.e. emphysema, obstruction of airways and decline in lung function. Emphysema has been proposed to be a deficiency of alveolar regeneration While this regenerative process is known to occur in fetal lung it can take place in normal adult lung [6]. The elevated expression of ECM proteins has been shown to be associated to increased number of myofibroblasts, which are alpha-smooth muscle actin (α-SMA) positive, spindle-shaped mesenchymal cells. The role of myofibroblasts in peripheral lung of smokers and in COPD has not yet been fully investigated, since most of the previous studies have focused on either large airways or other type of lung diseases

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