Respiratory bronchioles disease in patients without chronic air-flow limitation
Matsuba, K.; Kuwano, K.; Ikeda, T.; Shirakusa, T.; Shigematsu, N.
Nihon Kyobu Shikkan Gakkai Zasshi 26(12): 1267-1273
1988
ISSN/ISBN: 0301-1542 PMID: 3249495 Document Number: 322106
In order to investigate the relationship between pulmonary function and disease of the respiratory bronchioles (RB), we measured airway diameter and quantitated airway pathology scores in RB in 35 patients who required surgery for removal of a solitary nodule. The patients had FEV1 greater than 80% of the predicted value. Measurements of FEV1, nitrogen washout curve (.DELTA.N2/L), closing volume as a percentage of vital capacity (CV/VC%), and maximal flow rate at 50% of VC (.hivin.V50) were made prior to surgery. There were 21 smokers and 14 nonsmokers. There was 0.74 RB per cm2 of tissue. The mean internal RB diameter was 0.48 .+-. 0.10 mm. The total pathology scores for all RB were less than those found in North American populations. Inflammation scores were higher in patients with FEV1 less than 100% predicted (p<0.05). FEV1 values correlated with fibrosis (P<0.05), pigmentation (P<0.05), and intraluminal macrophages (P<0.05). Tests specific for small airways did not correlate with the pathology scores in RB. In conclusion, in 35 Japanese patients, some diseases in RB were detected in cases whose average age was 59.5 years (42 .apprx. 78 yrs) and FEV1 was greater than 80% of the predicted value. However, the diseases appeared to be affected little by smoking and changes were relatively minor in comparison with cases in North America. This degree of abnormality was considered to be also found in normal Japanese. Finally, it was supposed that an ordinary dpulmonary function test would not reveal the abnormality in RB that we detected.