Nonmuscular airway obstruction and asthma

Increased vascular density is a persistent feature of airway remodeling in a sheep model of chronic asthma

BACKGROUND

Increases in blood vessel density and vascular area are now recognized as important features of remodeled airways in asthma. However, the time sequence for these vascular changes and whether they resolve in the absence of continued antigenic exposure is not well elucidated. The aim of the present study was to correlate progressive changes in airway vascularity with changes in functional airway responses in sheep chronically challenged with house dust mite (HDM) allergen, and to examine the resolution of vascular remodeling following allergen withdrawal.

METHODS

Progressive changes in vascular indices were examined in four spatially separate lung segments that received weekly challenges with HDM allergen for 0, 8, 16, or 24 weeks. Reversibility of these changes was assessed in a separate experiment in which two lung segments received 24 weeks of HDM challenges and either no rest or 12 weeks rest. Lung tissue was collected from each segment 7 days following the final challenge and vascular changes assessed by a morphometric analysis of airways immunohistochemically stained with an antibody against type IV collagen.

RESULTS

Blood vessel density and percent airway vascularity were significantly increased in bronchi following 24 weeks of HDM challenges compared to untreated controls (P < .05), but not at any of the other time-points. There was no significant correlation between vascular indices and airway responses to allergic or nonspecific stimuli. The increase in blood vessel density induced by repeated allergen exposures did not return to baseline levels following a 12-week withdrawal period from allergen.

CONCLUSIONS

Our results show for the first time that the airways of sheep chronically exposed to HDM allergen undergo vascular remodeling. These findings show the potential of this large animal model for investigating airway angiogenesis in asthma.

Auxotonic contractile responses of rat tracheal and bronchial airway smooth muscle

The purposes of the present study were to directly compare: (1) the degree of trachealis muscle shortening and changes in tracheal dimensions and (2) ACh-mediated auxotonic contraction of trachea and intraparenchymal bronchi. The auxotonic contractile properties of tracheal and bronchial airway smooth muscle were assessed from 1-2 mm thick tracheal sections and;1 mm thick lung slices using videomicrometry in vitro at 37 degrees C. Acetylcholine resulted in reductions in luminal area, perimeter, mean radius, length, and breadth (22.0, 10.0, 11.9, 10.7 and 12.0%, respectively). Trachealis muscle shortening reached a maximum of 39.8+/-4.3%. The K(+)channel blocker 4-aminopyridine significantly augmented the ACh-mediated reductions in tracheal luminal dimensions. In response to ACh (10(-3)m), reductions in bronchial dimensions were significantly greater than those of the trachea for luminal area, perimeter and mean radius (44.6 vs. 18.6, 32.0 vs. 8.0 and 28.9 vs. 9.9%, respectively). These data indicate that auxotonic contractile responses of rat tracheal smooth muscle differ from those previously reported in the dog and guinea pig, that ACh-mediated auxotonic contraction of tracheal smooth muscle is augmented by 4-aminopyridine, and that proportionate reductions in luminal dimensions in response to ACh are considerably greater for bronchial than tracheal airways.

Quantitative and morphological analysis of the vascular bed in bronchial biopsy specimens from asthmatic and non-asthmatic subjects

BACKGROUND

This study was designed to establish the number and area (as a percentage) of bronchial wall vessels in subjects with and without asthma, to obtain information on the morphology of the vessels, and to see whether changes differed in patients with mild, moderate, and severe asthma.

METHODS

Biopsy specimens were taken using a rigid bronchoscope from the carina of the middle lobe bronchus of 20 patients with allergic asthma and 20 non-asthmatic controls. Specimens were sectioned and stained with haematoxylin-eosin, Masson trichrome, PAS, alcian blue-PAS, and orcein. The vessels were counted and the vascular area was calculated as a percentage in the lamina propria, in blind conditions, on PAS stained sections in 50 microscopic fields (magnification x1000, 0.02 mm(2) per field). The vascular area was calculated using the points counting procedure (Chalkley point array). The vascular morphology, intravascular cells, and the perivascular area were also studied using a magnification up to x1200.

RESULTS

Patients with asthma had more vessels (mean (SD) 226.70 (74.53) v 172.05 (30.58), p=0.0043) and a larger percentage vascular area (8.61 (2.38)% v 6.81 (2.25)%, p=0.028) than non-asthmatic subjects. Patients with severe asthma had significantly more vessels than those with mild or moderate disease (p=0.0044). Asthmatic capillaries and venules had oedematous walls and thickening of the subendothelial basement membrane, and hypotrophic or atrophic myocytes and fibrosis in the arterioles. Vessels from asthmatic subjects showed eosinophil recruitment, activation, and intravascular lysis. Intense eosinophil recruitment was associated with more marked vascular structural changes. Muscular formations protruded into the lumen in the arterioles of both groups, and in asthmatics these had hypotrophic or atrophic myocytes and fibrosis.

CONCLUSIONS

Morphometric analysis showed that the bronchial lamina propria of asthmatic subjects had a larger number of vessels, occupying a larger percentage area than in non-asthmatic subjects. The number of vessels was correlated with the severity of the asthma. Marked alterations to the vascular structure appeared to be associated with intense eosinophil recruitment and intravascular activation. This is the first report of asthmatic and non-asthmatic bronchial wall specimens containing intra-arteriolar muscular formations, presumably to regulate blood flow to the capillary network and/or sinusoids. This function might be impaired when these structures are remodelled in asthmatic patients.

Migration of eosinophils through basement membrane components in vitro: role of matrix metalloproteinase-9

In general, inflammatory cells cross basement membranes by producing proteinases. To investigate the role of proteinases in eosinophil basement membrane migration, we studied peripheral blood eosinophils in Matrigel-coated chemotaxis chambers. Electron microscopy showed degradation of the Matrigel layer when eosinophils, added to the upper chamber, transmigrated the membrane in the presence of both platelet-activating factor (PAF) in the lower chamber and interleukin (IL)-5 in both chambers. In the absence of either or both PAF and IL-5, no changes occurred in the Matrigel layer. Matrigel transmigration of eosinophils induced by PAF and IL-5 was inhibited by 1,10-phenanthroline, batimastat, 3,4-dichloroisocoumarin, chymostatin, and a neutralizing antibody for the matrix metalloproteinase (MMP)-9, indicating that serine proteinase(s) and MMP, specifically MMP-9, were involved in the transmigration of eosinophils through Matrigel. In contrast, eosinophil migration through a bare membrane was not affected by batimastat. Using gelatin zymography and immunoblotting, MMP-9 was detected in the migration upper chamber supernatant of the eosinophil transmigration assay and in the conditioned medium of eosinophils. Release of MMP-9 by eosinophils was increased by IL-5, PAF, or both, but the substrate-degrading activity of MMP-9 was increased only in the presence of both IL-5 and PAF, indicating that the releasing and activating mechanisms of MMP-9 are involved in eosinophil basement membrane migration. This study implicates MMP-9 in basement membrane migration of eosinophils and suggests its involvement in inflammatory diseases where tissue eosinophilia plays a role.