title: Epithelial regeneration after diffuse alveolar damage in relation to underlying disease and DAD stage: an autopsy study.
abstract: This study was conducted to characterize the distribution of epithelial regeneration in lungs with diffuse alveolar damage (DAD) and to ascertain whether epithelial regeneration is associated with the underlying disease and/or DAD stage.
  
  
  METHODS
  Lung specimens obtained at autopsy from 18 patients were studied using p63, PE-10 and Ki-67 immunostaining. The patients were categorized into two groups: patients with acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF; IPF group) and patients without IPF (non-IPF group).
  
  
  RESULTS
  p63-positive cells were mostly observed in the alveolar ducts. No significant difference in the appearance of the p63-positive cells was observed between the IPF and non-IPF groups or between the exudative and the proliferative stages. PE-10-positive cells were observed in the alveoli. The number of PE-10-positive cells was significantly higher during the proliferative stage than during the exudative stage. However, p63-positive cells and PE-10-positive cells appeared at day 6 in the earliest case during the exudative stage and Ki-67-positive cells were observed during the exudative stage.
  
  
  CONCLUSIONS
  Epithelial regeneration was not associated with the underlying disease. This study revealed that regenerative epithelial cells appeared at day 6 during the exudative stage and that the number of type Ⅱ pneumocytes increased significantly during the proliferative stage.
authors.affiliation: Department of Intensive Care Unit, Japanese Red Cross Medical Center.
authors.forename: Satoru
authors.initials: S
authors.lastname: Asano
authors.forename: Tamiko
authors.initials: T
authors.lastname: Takemura
authors.forename: Keiichi
authors.initials: K
authors.lastname: Katoh
authors.forename: Masuzoh
authors.initials: M
authors.lastname: Taneda
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kitagawa
mesh_terms: D055371:Acute Lung Injury / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056809:Alveolar Epithelial Cells / Q000473:pathology; D055745:Bronchioles / Q000473:pathology; D002102:Cadaver; D049109:Cell Proliferation; D004847:Epithelial Cells / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia; D054990:Idiopathic Pulmonary Fibrosis / Q000473:pathology; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008565:Membrane Proteins / Q000032:analysis; D008679:Metaplasia; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000473:pathology*; D011663:Pulmonary Surfactants / Q000032:analysis; D062326:Re-Epithelialization / Q000502:physiology*; D012038:Regeneration / Q000502:physiology; D012121:Respiration, Artificial
chemical_list: C081876:CKAP4 protein, human; D019394:Ki-67 Antigen; D008565:Membrane Proteins; D011663:Pulmonary Surfactants