Airway dimensions in bronchopulmonary dysplasia: Implications for airflow obstruction

• Published in: Pediatric pulmonology Vol. 43; no. 12; pp. 1206 - 1213
• Main Authors: Tiddens, Harm A.W.M., Hofhuis, Ward, Casotti, Valeria, Hop, Wim C., Hulsmann, Anthon R., de Jongste, Johan C.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.12.2008; Wiley-Liss
• Subjects: Airway Obstruction; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; bronchopulmonary dysplasia; Bronchopulmonary Dysplasia - pathology; Bronchopulmonary Dysplasia - physiopathology; Chronic obstructive pulmonary disease, asthma; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Female; General aspects; Humans; Infant, Newborn; Intensive care medicine; Male; Medical sciences; morphology; Pneumology; Pulmonary Ventilation; Respiratory system : syndromes and miscellaneous diseases; sudden infant death; Human; Premature; Lung disease; Pediatrics; Cardiocirculatory arrest; Respiratory disease; Sudden death; Cardiovascular disease; Infant; Dimension; airway obstruction; Newborn diseases; Air flow; sudden infant death; Morphology; Bronchus disease; Bronchopulmonary dysplasia; Airways obstruction; Pneumology
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.20928

The cause of lung function abnormalities in bronchopulmonary dysplasia (BPD) is incompletely understood, even in the “new era” of this disease. Altered airway wall dimensions are important in the pathogenesis of airflow obstruction in diseases such as asthma and chronic obstructive pulmonary disease. Whether airway wall dimensions contribute to lung function abnormalities in BPD is unknown. The purpose of this study was to investigate airway wall dimensions in relation to airway size in BPD. Lung tissue of patients with BPD was obtained at autopsy, and lung tissue from children who died from sudden infant death syndrome (SIDS) served as control. Airway wall dimensions and epithelial loss were measured in 75 airways from 5 BPD patients and 176 airways from 11 SIDS patients. Repeated measures analysis of variance was used to assess the relationships between airway wall dimensions and airway size for BPD and SIDS patients. Little epithelial loss was present in the BPD patients while extensive loss was observed in some of the SIDS patients. The inner wall area, outer wall area, epithelium area and smooth muscle area were all substantially larger (all P < 0.001) in BPD than in SIDS patients. It is likely that the increased thickness of the airway wall components contributes to airflow obstruction in BPD patients. Pediatr. Pulmonol. 2008; 43:1206–1213. © 2008 Wiley‐Liss, Inc.