Association between reduced bronchodilatory effect of deep inspiration and loss of alveolar attachments.
BACKGROUND
We have previously shown that the bronchodilatory effect of deep inspiration is attenuated in individuals with COPD. This study was designed to investigate whether the impairment in this effect is associated with loss of alveolar attachments.


METHODS
We measured deep inspiration (DI)-induced bronchodilation in 15 individuals with and without COPD (67 +/- 2.2 yrs of age, mean +/- SEM) undergoing lobar resection for peripheral pulmonary nodule. Prior to surgery, we measured TLCO and determined the bronchodilatory effect of deep inspiration after constricting the airways with methacholine. The number of destroyed alveolar attachments, as well as airway wall area and airway smooth muscle area, were determined in tumor-free, peripheral lung tissue.


RESULTS
The bronchodilatory effect of deep inspiration correlated inversely with the % destroyed attachments (r = -0.51, p = 0.05) and directly with the airway smooth muscle area (r = 0.59, p = 0.03), but not with the total wall area (r = 0.39, p = 0.15).


CONCLUSIONS
We postulate that attenuation of airway stretch due to loss of alveolar attachments contributes to the loss of the bronchodilatory effect of lung inflation in COPD.
Scichilone
Nicola
N
Istituto di Medicina Generale e Pneumologia, Cattedra di Malattie dell'Apparato Respiratorio, Università di Palermo, via Trabucco 180, 90146 Palermo, Italy. n.scichilone@libero.it
Bruno
Andreina
A
Marchese
Roberto
R
Vignola
Antonio Maurizio
AM
Togias
Alkis
A
Bellia
Vincenzo
V
D000368:Aged; D001980:Bronchi / Q000473:pathology* / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D005260:Female; D006801:Humans; D001239:Inhalation; D008297:Male; D016210:Methacholine Chloride; D011650:Pulmonary Alveoli / Q000473:pathology* / Q000503:physiopathology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology*; D013223:Statistics as Topic
D016210:Methacholine Chloride