title: Chronic bronchitis and current smoking are associated with more goblet cells in moderate to severe COPD and smokers without airflow obstruction.
abstract: BACKGROUND
  Goblet cell hyperplasia is a classic but variable pathologic finding in COPD. Current literature shows that smoking is a risk factor for chronic bronchitis but the relationship of these clinical features to the presence and magnitude of large airway goblet cell hyperplasia has not been well described. We hypothesized that current smokers and chronic bronchitics would have more goblet cells than nonsmokers or those without chronic bronchitis (CB), independent of airflow obstruction.
  
  
  METHODS
  We recruited 15 subjects with moderate to severe COPD, 12 healthy smokers, and 11 healthy nonsmokers. Six endobronchial mucosal biopsies per subject were obtained by bronchoscopy and stained with periodic acid Schiff-Alcian Blue. Goblet cell density (GCD) was quantified as goblet cell number per millimeter of basement membrane. Mucin volume density (MVD) was quantified as volume of mucin per unit area of basement membrane.
  
  
  RESULTS
  Healthy smokers had a greater GCD and MVD than nonsmokers and COPD subjects. COPD subjects had a greater GCD than nonsmokers. When current smokers (healthy smokers and COPD current smokers, n = 19) were compared with all nonsmokers (nonsmoking controls and COPD ex-smokers, n = 19), current smokers had a greater GCD and MVD. When those with CB (n = 12) were compared to those without CB (n = 26), the CB group had greater GCD. This finding was also seen in those with CB in the COPD group alone. In multivariate analysis, current smoking and CB were significant predictors of GCD using demographics, lung function, and smoking pack years as covariates. All other covariates were not significant predictors of GCD or MVD.
  
  
  CONCLUSIONS
  Current smoking is associated with a more goblet cell hyperplasia and number, and CB is associated with more goblet cells, independent of the presence of airflow obstruction. This provides clinical and pathologic correlation for smokers with and without COPD.
authors: Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors: Victor
authors: V
authors: Kim
authors: Department of Pathology, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors: Michelle
authors: M
authors: Oros
authors: Department of Pathology, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors: Heba
authors: H
authors: Durra
authors: Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors: Steven
authors: S
authors: Kelsen
authors: Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors: Mark
authors: M
authors: Aksoy
authors: Center for Inflammation, Translational and Clinical Lung Research, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors: William D
authors: WD
authors: Cornwell
authors: Center for Inflammation, Translational and Clinical Lung Research, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors: Thomas J
authors: TJ
authors: Rogers
authors: Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors: Gerard J
authors: GJ
authors: Criner
mesh_terms: D000328:Adult; D000368:Aged; D029481:Bronchitis, Chronic / Q000150:complications* / Q000473:pathology; D016022:Case-Control Studies; D002452:Cell Count; D005260:Female; D020397:Goblet Cells / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000378:metabolism / Q000473:pathology*; D012907:Smoking / Q000473:pathology
chemical_list: D009077:Mucins
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