title: Measuring Airway Remodeling in Patients With Different COPD Staging Using Endobronchial Optical Coherence Tomography.
abstract: BACKGROUND
  Although FEV1remains the gold standard for staging COPD, the association between airway remodeling and airflow limitation remains unclear. Endobronchial optical coherence tomography (EB-OCT) was performed to assess the association between disorders of large and medium to small airways and COPD staging. We also evaluated small airway architecture in heavy smokers with normal FEV1(SNL) and healthy never-smokers.
  
  
  METHODS
  We recruited 48 patients with COPD (stage I, n = 14; stage II, n = 15; stage, III-IV, n = 19), 21 SNL, and 17 healthy never-smokers. A smoking history inquiry, as well as spirometry, chest CT, bronchoscopy, and EB-OCT were performed. Mean luminal diameter (Dmean), inner luminal area (Ai), and airway wall area (Aw) of third- to ninth-generation bronchi were measured using EB-OCT.
  
  
  RESULTS
  Patients with more advanced COPD demonstrated greater abnormality of airway architecture in both large and medium to small airways, followed by SNLand never-smokers. Abnormality of airway architecture and EB-OCT parameters in SNLwere comparable to those in stage I COPD. FEV1% predicted correlated with Dmeanand Ai of seventh- to ninth-generation bronchi in COPD; however, neither Dmeannor Ai of third- to sixth-generation bronchi correlated with FEV1% in stage I and stage II COPD and in SNL.
  
  
  CONCLUSIONS
  FEV1-based COPD staging partially correlates with small airway disorders in stage II-IV COPD. Small airway abnormalities detected by EB-OCT correlate with FEV1-based staging in COPD and identify early pathologic changes in healthy heavy smokers.
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Ming
authors: M
authors: Ding
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Yu
authors: Y
authors: Chen
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Wei-Jie
authors: WJ
authors: Guan
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Chang-Hao
authors: CH
authors: Zhong
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Mei
authors: M
authors: Jiang
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Wei-Zhan
authors: WZ
authors: Luo
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Xiao-Bo
authors: XB
authors: Chen
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Chun-Li
authors: CL
authors: Tang
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Yan
authors: Y
authors: Tang
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Qi-Ming
authors: QM
authors: Jian
authors: Department of Cardiology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Wei
authors: W
authors: Wang
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China. Electronic address: lishiyue@188.com.
authors: Shi-Yue
authors: SY
authors: Li
authors: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors: Nan-Shan
authors: NS
authors: Zhong
mesh_terms: D056151:Airway Remodeling; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging* / Q000473:pathology*; D012129:Respiratory Function Tests; D012907:Smoking / Q000009:adverse effects; D041623:Tomography, Optical Coherence
keywords: COPD; endobronchial optical coherence tomography; heavy smokers; stage