The Characteristics And The Relationship On Small-Airway And Pulmonary Vasculature Inflammation In Chronic Obstructive Pulmonary Disease

Objective To investigate the characteristics and the relationship on smallairway inflammation and pulmonary vasculature inflammation in Chronic Obstructive Pulmonary Disease.Methods The patients enrolled in surgical treatment of peripheral lung tumors at theⅠorⅡstage were divided into three groups:A group (Nonsmokers with normal lung function,n=10);B group(Smokers with normal lung function,n=10);C group(Smokers with airflow obstruction,n=10).We recorded the clinical data before the operation.The lung tissues obtained from the patients were fixed by immersion in 10%formalin when the lungs and lobes were resected.Samples of fixed tissue were processed into paraffin blocks and cut into the sections consecutively.The pathomorphological changes of the small-airways and intra-acinar pulmonary arteries were observed by stained with hematoxylin-eosin.The three types of intra-acinar pulmonary arteries were observed by stained with elstic van Gieson.Immunohistochemical expression of the total T-lymphocytes,CD4~+T-lymphocytes,CD8~+T-lymphocytes and B lymphocytes infiltrated in small-airways and pulmonary vasculature were observed.The characteristics and the correlations between small airway inflammation and pulmonary vasculature inflammation were analyzed.Results(1)The total pathologic scores of small-airway in three groups was 51.27±10.45,104.26±33.57,163.27±35.65,respectively and the significant difference were found among three groups(all P＜0.01).T-lymphocytes, specifically CD8~+T-lymphocytes infiltrated in the adventitia of small-airways and pulmonary vasculature were the characteristics in B and C group.Compared with A group(1.40±0.49),the CD4/CD8 on tubal wall of small-airways in B group and C group were(0.93±0.19,0.84±0.16),respectively and the significant difference were found(all P＜0.05).Compared with A group(1.25±0.34),the CD4/CD8 on pulmonary vasculature in B group and C group were(0.87±0.41, 0.74±0.17),respectively and the significant difference were found(P＜0.05, P＜0.01,respectively).The proportion of MA in B and C group were (28.62±6.09,34.11±7.48),respectively and the significant difference were found compared with A group(19.66±8.80).(2)In B and C group,there were positive correlations between the lymphocytes infiltrated(cells/mm~2)in the adventitia of intra-acinar pulmonary muscular arteries and the total pathologic scores of airway(r=0.716,P=0.020;r=0.751,P=0.012).In B group,there were significant positive relationships between the total T-lymphocytes, CD8~+T-lymphocytes infiltrated(cells/mm~2)in the adventitia of intra-acinar pulmonary muscular arteries and the adventitia of small-airway(r=0.703, P=0.023;r-0.717,P=0.020).In C group,there were significant positive relationships between the total T-lymphocytes,CD8~+T-lymphocytes infiltrated (cells/mm~2)in the adventitia of intra-acinar pulmonary muscular arteries and the adventitia of small-airway(r=0.731,P=0.016,r=0.778,P=0o008).In B group, there were positive correlations between the total T-lymphocytes, CD8~+T-lymphocytes infiltrated(cells/ram~2)in the adventitia of small-airway and the smoking index(r=0o677,P=0.031;r=0.712,P=0.021).In C group,there were positive correlations between the total T-lymphocytes,CD8~+T-lymphocytes infiltrated(cells/mm~2)in the adventitia of small-airway and the smoking index (r=0.649,P=0.042;r=0.748,P=0.013).In all smokers,there were positive correlations between the total T-lymphocytes,CD4~+T-lymphocytes, CD8~+T-lymphocytes infiltrated(cells/mm~2)in the adventitia of small-airway and the smoking index(r=0.680,P=0.001;r=0.475,P=0.034;r=0.0.713,P=0.000). In B group,there were positive correlations between the total T-lymphocytes, CD8~+T-lymphocytes infiltrated(cells/mm~2)in the adventitia of intra-acinar pulmonary muscular arteries and the smoking index(r=0.641,P=0.046;r=0.675, P=0.032).In C group,there were positive correlations between the total T-lymphocytes,CD8~+T-lymphocytes infiltrated(cells/mm~2)in the adventitia of intra-acinar pulmonary muscular arteries and the smoking index(r=0.678, P=0.031;r=0.644,P=0.045).In all smokers,there were positive correlations between the total T-lymphocytes,CD8~+T-lymphocytes infiltrated(cells/mm~2)in the adventitia of intra-acinar pulmonary muscular arteries and the smoking index (r=0.675,P=0.001;r=0.686,P=0.001).Conclusions(1)T-lymphocytes,specifically CD8~+T-lymphocytes infiltrated in the adventitia of small-airways and pulmonary vasculature were the characteristics of small-airway and pulmonary vasculature inflammation in Smokers and COPD group.The characteristics of inflammation were same and colsely correlated in pulmonary vasculature and small-airway.(2)The inflmmations in small-airway and pulmonary vasculature were positive correlated with smoking index.Smoking may be one of the major etiological factors involved in small-airway and pulmonary vasculature inflammation.(3) Pulmonary vasculature remolding has been observed in smokers with normal lung function group.