• George Castro Figueira de Mello, Carlos Roberto Ribeiro Carvalho, Adib Kairalla Ronaldo R, Paulo Hilário Nascimento Saldiva, Sandra Fernezlian, Luiz Fernando Ferraz Silva, Marisa Dolhnikoff, and Thais Mauad.
• Pathology Department, Hospital das Clinicas, University of Sao Paulo Medical School, São Paulo, Brazil.
• Respiration. 2010 Jan 1; 79 (4): 322-32.

BackgroundFew studies have addressed small airway (SA) histopathological changes and their possible role in the remodeling process in idiopathic interstitial pneumonias.ObjectivesTo study morphological, morphometrical and immunohistochemical features of SA in idiopathic pulmonary fibrosis (usual interstitial pneumonia, UIP) and nonspecific interstitial pneumonia (NSIP).MethodsWe analyzed SA pathology in lung biopsies from 29 patients with UIP and 8 with NSIP. Biopsies were compared with lung tissue from 13 patients with constrictive bronchiolitis (CB) as positive controls and 10 normal autopsied control lungs. We semi-quantitatively analyzed SA structure, inflammation, architectural features and the bronchiolar epithelial immunohistochemical expression of TGF-beta, MMP-2, 7, 9, and their tissue inhibitors (TIMP-1, 2).ResultsCompared to controls, patients with UIP, NSIP and CB presented increased bronchiolar inflammation, peribronchiolar inflammation and fibrosis and decreased luminal areas. UIP patients had thicker walls due to an increase in most airway compartments. NSIP patients presented increased epithelial areas, whereas patients with CB had larger inner wall areas. All of the groups studied presented increased bronchiolar expression of MMP-7 and MMP-9, compared to the controls.ConclusionWe conclude that SAs are pathologically altered and may take part in the lung-remodeling process in idiopathic interstitial pneumonias.Copyright 2009 S. Karger AG, Basel.

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