Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 8

Changes in the airway lumen and surrounding parenchyma in chronic obstructive pulmonary disease

Authors Kurashima K, Hoshi T, Takaku Y, Kanauchi T, Nakamoto K, Ueda M, Takayanagi N, Colby TV, Sugita Y, Kawabata Y

Received 7 August 2013

Accepted for publication 18 September 2013

Published 30 October 2013 Volume 2013:8 Pages 523—532

DOI https://doi.org/10.2147/COPD.S52637

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Kazuyoshi Kurashima,1 Toshiko Hoshi,2 Yotaro Takaku,1 Tetsu Kanauchi,2 Keitaro Nakamoto,1 Miyuki Ueda,2 Noboru Takayanagi,1 Thomas V Colby,4 Yutaka Sugita,1 Yoshinori Kawabata3

1Department of Respiratory Medicine, 2Department of Radiology, 3Department of Pathology, Saitama Cardiovascular and Respiratory Center, Kumagaya City, Saitama, Japan; 4Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, AZ, USA

Background: The purpose of this study was to examine changes in the airway lumen and parenchyma in relation to lung function in patients with chronic obstructive pulmonary disease (COPD) compared with controls.
Methods: We studied 70 patients with COPD and 15 normal subjects. Using reconstructed computed tomography (CT) images, we traced the bronchial trees and reconstructed 3 cm circle images around the airways exactly perpendicular to the airway axis at the peripheral, middle, and central zones of the bronchi. We measured the number of airways and vessels, the airway inner diameter, and the area of emphysema in the circles, and analyzed the relationship of these image parameters to lung function.
Results: Reduced airway numbers and increased upper lobe emphysema were observed even in early spirometric stages in patients with COPD compared with controls. Other findings included decreased airway inner diameter in advanced spirometric stages. The numbers of peripheral zone bronchi, the extent of the middle zone emphysematous area, and the mean airway inner diameter of the airways were the best predictors of spirometric parameters. A portion of the airways in patients with COPD showed a loss of airway patency at middle or central zone bronchi predominantly in the late spirometric stages. Lumen-obliterated bronchial trees could be traced into emphysematous areas showing air trapping.
Conclusion: Compared with controls, our CT observations in patients with COPD showed that airway lumen and lung parenchyma changes along airways differed by spirometric stage, and these changes were associated with decreased lung function. A portion of CT-identified emphysema in patients with COPD appeared to be due to lumen-obliterated airways in the bronchial tree.

Keywords: airway dimension, computed tomography, emphysema, pulmonary functions

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other articles by this author:

COPD assessment test and severity of airflow limitation in patients with asthma, COPD, and asthma–COPD overlap syndrome

Kurashima K, Takaku Y, Ohta C, Takayanagi N, Yanagisawa T, Sugita Y

International Journal of Chronic Obstructive Pulmonary Disease 2016, 11:479-487

Published Date: 4 March 2016

Lobe-based computed tomography assessment of airway diameter, airway or vessel number, and emphysema extent in relation to the clinical outcomes of COPD

Kurashima K, Takaku Y, Hoshi T, Kanauchi T, Nakamoto K, Takayanagi N, Yanagisawa T, Sugita Y, Kawabata Y

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1027-1033

Published Date: 2 June 2015

Readers of this article also read:

Management of COPD in the UK primary-care setting: an analysis of real-life prescribing patterns

Price D, West D, Brusselle G, Gruffydd-Jones K, Jones R, Miravitlles M, Rossi A, Hutton C, Ashton VL, Stewart R, Bichel K

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:889-905

Published Date: 27 August 2014

Chronic obstructive pulmonary disease exacerbation frequency and severity

Stafyla E, Kerenidi T, Gourgoulianis KI

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:533-535

Published Date: 6 November 2013

Day-to-day measurement of patient-reported outcomes in exacerbations of chronic obstructive pulmonary disease

Kocks JWH, van den Berg JWK, Kerstjens HAM, Uil SM, Vonk JM, de Jong YP, Tsiligianni IG, van der Molen T

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:273-286

Published Date: 6 June 2013