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SHR Neuro Cancer Cardio Lipid Metab Microb
Zeder, K; Marsh, LM; Avian, A; Brcic, L; Birnhuber, A; Douschan, P; Foris, V; Sassmann, T; Hoetzenecker, K; Boehm, PM; Kwapiszewska, G; Olschewski, A; Olschewski, H; Kovacs, G.
Compartment-specific remodeling patterns in end-stage chronic obstructive pulmonary disease with and without severe pulmonary hypertension.
J Heart Lung Transplant. 2024; 43(7):1090-1101
Doi: 10.1016/j.healun.2024.02.1044
Web of Science
PubMed
FullText
FullText_MUG
- Leading authors Med Uni Graz
- Olschewski Horst
- Zeder Katarina Eleonora
- Co-authors Med Uni Graz
- Avian Alexander
- Birnhuber Anna
- Brcic Luka
- Douschan Philipp
- Foris Vasile
- John Teresa
- Kovacs Gabor
- Kwapiszewska-Marsh Grazyna
- Marsh Leigh
- Olschewski Andrea
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- Abstract:
- BACKGROUND: In patients with end-stage chronic obstructive pulmonary disease (COPD), severe pulmonary hypertension (PH) is frequently associated with less severe airway obstruction as compared to mild or no PH. However, the histologic correlate of this finding is not clear. We aimed to quantify remodeling of pulmonary arteries, airways, and parenchyma in random samples of explanted end-stage COPD lungs. METHODS: We quantified remodeling of small pulmonary arteries, small airways, and the degree of emphysema (mean interseptal distance [MID]) with dedicated software. As primary objective, we compared COPD patients with severe PH (SevPH-COPD) with age- and sex-matched MildPH-COPD. For comparison, we also investigated COPD lungs with no PH (NoPH-COPD), idiopathic PAH (IPAH), and healthy donors. RESULTS: We included n = 17 SevPH-COPD (mPAP = 43 [39-45]mm Hg), n = 17 MildPH-COPD (mPAP = 28 [24-31]mm Hg), n = 5 NoPH-COPD (mPAP = 18 [16-19]mm Hg), n = 10 IPAH (mPAP = 72 [65-91]mm Hg), and n = 10 healthy donor lungs. SevPH-COPD versus MildPH-COPD was characterized by better preserved forced vital capacity (51% vs 40% predicted, p < 0.05), less emphysema (MID 169 µm vs 279 µm, p < 0.001), and less PAS-positive and CD45-positive mucosa cells (15% vs 22%, p = 0.063% and 5% vs 7%, p = 0.058) suggesting less airway inflammation. In COPD patients, intimal and medial thickening were strongly correlated with mPAP (r = 0.676, p < 0.001 and r = 0.595, p < 0.001). MID was negatively correlated with mPAP (r = -0.556, p < 0.001) and was highest in NoPH-COPD (mean 281 µm), suggesting that emphysema per se is not associated with PH. CONCLUSIONS: End-stage COPD with severe PH is characterized by pronounced pulmonary vascular remodeling, less inflammation of small airways, and less emphysema as compared to COPD with mild PH or no PH, suggesting that COPD with severe PH may represent a unique phenotype of COPD.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Pulmonary Disease, Chronic Obstructive - physiopathology, complications, pathology
- Male - administration & dosage
- Female - administration & dosage
- Hypertension, Pulmonary - physiopathology, etiology
- Middle Aged - administration & dosage
- Vascular Remodeling - physiology
- Severity of Illness Index - administration & dosage
- Aged - administration & dosage
- Pulmonary Artery - pathology, physiopathology
- Airway Remodeling - physiology
- Lung - physiopathology, pathology
- Retrospective Studies - administration & dosage
- Find related publications in this database (Keywords)
- histology
- pulmonary hypertension
- chronic obstructive pulmonary disease
- remodeling
- emphysema