The applicability of the gland/wall ratio (Reid-Index) to clinicopathological correlation studies.

Abstract

and Rohr, H P (1978). Thorax, 33,[779][780][781][782][783][784]. The applicability of the gland/wall ratio (Reid-Index) to clinicopathological correlation studies. We studied at necropsy the bronchi of 49 subjects whose lung function had been measured during life. In each case the glands were examined in three bronchi by measuring the gland/wall ratio (Reid-Index) and by point-counting. The results of the two methods were compared: the data of the gland/wall ratio were normally distributed while those of the volume density established by point-counting were not. Gland/wall ratio and volume density of glands correlated moderately (Rsp=0 524). The function between them was not linear, in contrast with that between gland/wall ratio and gland thickness. The stereological background of these functions is discussed. In 34 subjects without restrictive lung disease FEV1 correlated inversely with the volume density of glands (Rsp= -0 396), but not with the gland/wall ratio (Reid-Index) (Rsp -0 243). This discrepancy probably results from the different distribution of the data obtained by the two methods and from the non-linear function between them. These findings indicate that the gland/wall ratio (Reid-Index) is less applicable to clinicopathological correlations than the volume density of glands established by point-counting.The ratio gland/wall thickness measured between cartilage and epithelial basement membrane was introduced by Reid (1960) as a measurement of chronic bronchitis. Dunnill (1962) suggested the point-counting method for measurement ofthe glands in chronic bronchitis. This method has some advantages:(1) Glands and other compartments of the bronchial wall can be measured simultaneously.(2) All glands of a section of bronchus are covered by the measurement. (3) Results are not influenced by wrinkling of the bronchial mucosa. Both methods have been applied to clinicopathological studies. The results, especially those of correlations between Reid-Index and FEV1 (forced expiratory volume in 1 second) are conflicting (Bath et al, 1968;Boushy et al, 1970;Thurlbeck et al, 1970;Lyons et al, 1972). Some authors have discussed the Reid-Index as "yardstick of chronic bronchitis" (Thurlbeck and Angus, 1964;1967;Hartung and Meyer-Carlstadt, 1968;Dunnill et al, 1969;Bedrossian et al, 1971;Takizawa and Thurlbeck, 1971 Bronchitis, 1975). The purpose of this study is to scrutinise the applicability of Reid-Index and volume density of bronchial glands established by point-counting to clinicopathological correlations. Material and methodsLungs taken at necropsy from 41 men and 8 women were studied. The mean age of the subjects was 65-4 (38-81) years. Forty-five had had lung function tests within an average of 18 months before death. We have unpublished evidence that this time-lag does not affect correlations between volume density of glands and lung function tests. The tests included measurements of total lung capacity (TLC), vital capacity (VC), residual volume (RV), FEV1 as % VC or as % of predicted value, and resis...

Airway Gland Structure and Function

“…In one study the Reid index increased from a control of 0.21 to 0.53 (545); in a second, from 0.32 to 0.53 (56). These changes in Reid index in CF correspond to increases in gland volume percent of 2.0-and 4.3-fold (475). Most recently, in second-to fourth-generation airways, gland volume per unit area of surface (as determined by stereology) has been shown to increase by 2.8-fold in CF (259).…”

“…A second general approach to measuring total gland volume is to use point-counting to calculate "gland volume percent," the percentage of wall volume occupied by glands in a histological section (174). This has the advantage that it includes the glands between the cartilaginous rings, and evidence of its utility is that FEV 1 /FVC correlates negatively with gland volume percent but shows no correlation with the Reid index (475). A major disadvantage of this technique, shared with the Reid index, is that changes in the dimensions of other components of the lung wall will affect the volume percent of glands.…”

CFTR and calcium-activated chloride channels in primary cultures of human airway gland cells of serous or mucous phenotype

“…Thus maximal secretory rates from human airway glands in response to carbachol were ϳ3 nl/min per gland and not significantly altered in CF (7). Of course, glands are ϳ3 times the normal volume in CF (3,39), and correcting for this hypertrophy suggests that the CaCCmediated gland secretion rate in non-CF tissues is ϳ1 nl/min. Two-thirds of the carbachol-stimulated secretion (i.e., 2 nl/ min) would therefore be mediated by CFTR via a hyperpolarization of the apical membrane.…”

A Comparative Histological Study Of Submucosal Gland Hypertrophy In Trachea Of Mice Exposed To Cigarette And Shisha Smoke

“…17 Reid in 1960 used a method to assess submucosal gland hypertrophy by taking proportion of gland thickness to bronchial wall thickness. 10 This ratio is referred to as the Reid's Index. This method has the advantage that the measurements include all the submucosal glands and it is not affected by the wrinkling of the mucosa.…”

“…The histological features were studied under 40X objective of a light microscope and Reid's Index was calculated. 10 Reid's Index is a ratio of submucosal gland to wall thickness, and is used to assess submucosal gland hypertrophy. In the slides of the trachea, the maximal gland thickness was measured on a line at right angles to the plane of the cartilage.…”