Abstract
Clinical assessment of airway wall remodeling by means of evaluated the thickness of reticular basement membrane by endobronchial biopsy has been correlated to the central airway structural changes. It has not been known whether it also reflects airway wall remodeling in the peripheral airways. This study was performed to determine the relationship between reticular basement membrane thickening and airway wall dimensions in asthma. The thickness of the reticular basement membrane was measured from autopsy samples that are equivalent to central airway biopsies, from both central and peripheral airways. For each of these measurements the dimension of the transverse section of the airway wall was recorded. This study focused on victims who had died from asthma (fatal asthma, n=3) or from asthmatics who had died from unrelated causes (non-fatal asthma, n=3) . Cases without asthma (control cases n=4) were included as controls. Reticular basement membrane thickness correlated with smooth muscle area (p<0.05), submucosal gland area (p<0.05), and inner wall area (p<0.01) in central airways. In peripheral airways reticular basement membrane thickness correlated with smooth muscle area (p<0.05) and inner wall area (p<0.01) but not with airway size, lumen area, and outer wall area. These results show that the thickness of the reticular basement membrane of central airways reflects airway remodeling in the central airways and smooth muscle and inner wall area in the peripheral airways. Reticular basement membrane thickness measurements may be taken from endobronchial biopsies and used to assess the pathology of airways for long-term follow-up investigations of asthma patients.
