The Morphological Spectrum of Aging and Emphysematous Lungs

Azcuy, A.

doi:10.7326/0003-4819-57-1-1

Cited by 22 publications

(6 citation statements)

References 17 publications

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“…It has been observed recently that enlarged air spaces and destruction of septa resembling, in all ways, the pathological changes described in pulmonary emphysema appear in the lungs of most elderly men (Snider, Brody, and Doctor, 1962;Azcuy, Anderson, and Foraker, 1962;Thurlbeck, 1963;and Wyatt, Fischer, and Sweet, 1964). Our study also demonstrates that these lesions are found more commonly in men than in women, and that they increase in prevalence with increasing age.…”

Section: Discussionmentioning

confidence: 96%

Fibrous Network of the Lung and its Change with Age

Pierce¹,

Ebert²

1965

Thorax

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The remarkable elastic behaviour of the lung entails both continuous tissue stress and a cyclic stress produced by the fluctuating difference between intrathoracic and intra-alveolar pressures throughout the entire span of life. In spite of these potentially disruptive forces, lung structure is preserved by the fibrous connective-tissue proteinscollagen, elastin, and reticulin. These extracellular proteins are characterized by their insolubility, resistance to destruction, and high tensile strength. Collagen and elastin both exhibit elastic behaviour, but great extensibility is a property only of elastin. The most reasonable assumption is that the elastic fibres, therefore, are principally responsible for the elastic behaviour of the lung tissue, but sure proof is lacking.Recently, Carton, Dainauskas, Tews, and Hass (1960) and Wright (1961) have described the nature of the network of elastic tissue in the lung. We sought to describe more fully the roles of collagenous and elastic fibres in the terminal air spaces of the lung, and thus their respective contributions to tissue elasticity and the general elastic performance of the lung. As the study developed, it seemed important to measure the amounts of collagen and elastin in the lung parenchyma and pleura. These findings have been correlated with the age of the subjects and interpreted according to knowledge about tissue elasticity. METHODSThe study was based on 36 human lungs taken from patients who had died of a variety of diseases. No lungs were taken from patients with a history of cough, sputum production, dyspnoea, or chronic pulmonary disease, or from patients whose clinical history was incomplete. Of these 36, 27 lungs were dried in an inflated state by the extraction process using dilute (0-1 N) sodium hydroxide solution (Pierce, Hocott, and Ebert, 1959). Nine more lungs were also dried in the inflated state but were fixed with formalin vapour. The advantage of the alkaline extraction method is that it permits the morphology of the lung 1 Supported in part by grants HTS5333 and HE04031 from the U.S. Public Health Service to be examined and also the quantities of collagen and elastin to be measured.The lungs were cut into thin slices and examined grossly and with a stereomicroscope. Slices of tissue were variously stained (Lillie, 1954) but not embedded. Elastic tissue was stained by the Taenzer-Unna acidorcein method (in absolute ethanol); Van Gieson's picric acid-acid fuchsin mixture was used to stain collagen; and Fraenkel's method of using orcein and indigo-carmine was employed to stain both collagen and elastin in the same slice. All slices were rapidly dehydrated in alcohol and then in ether, and dried in vacuo to prevent collapse. This procedure enabled one to study the structure of the alveoli, alveolar ducts, and respiratory bronchioles as well as to visualize the relationship of the fibres in three dimensions. Preparations extracted with sodium hydroxide provided a more clearly defined fibrous network than did the formalin-vapour preparation...

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Section: Discussionmentioning

confidence: 96%

Fibrous Network of the Lung and its Change with Age

Pierce¹,

Ebert²

1965

Thorax

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“…The cable line element maintains septal length by balancing the effect of surface forces within the alveolus (Wilson and Bachofen, ); the cable line element also maintains alveolar surface area during exercise‐associated changes in lung volume (Weibel, ). In adults, disruption of the cable leads to the impairment of both ventilation and gas exchange common to diseases such as emphysema (Azcuy et al, ). Congenital defects in the cable line element lead to the profound lung dysfunction associated with bronchopulmonary dysplasia (Hadchouel et al, ).…”

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confidence: 99%

Extracellular Assembly of the Elastin Cable Line Element in the Developing Lung

Valenzuela

Wagner

Bennett

et al. 2017

The Anatomical Record

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In the normal lung, a dominant structural element is an elastic "line element" that originates in the central bronchi and inserts into the distal airspaces. Despite its structural importance, the process that leads to development of the cable line element is unknown. To investigate the morphologic events contributing to its development, we used optical clearing methods to examine the postnatal rat lung. An unexpected finding was numerous spheres, with a median diameter of 1-2 µm, within the primary septa of the rat lung. The spheres demonstrated green autofluorescence, selective fluorescent eosin staining, reactivity with carboxyfluorescein succinimidyl ester, and specific labeling with anti-tropoelastin monoclonal antibody-findings consistent with tropoelastin. The sphere number peaked on rat postnatal day 4 (P4) and were rare by P14. The disappearance of the spheres was coincident with the development of the cable line element in the rat lung. Transmission electron microscopy demonstrated no consistent association between parenchymal cells and sphere alignment. In contrast, the alignment of tropoelastin spheres appeared to be the direct result of interactions of scaffold proteins including collagen fibers and fibrillin microfibrils. We conclude that the spatial organization of the cable line element appears to be independent of tropoelastin deposition, but dependent on crosslinking to scaffold proteins within the primary septa. Anat Rec, 300:1670-1679, 2017. © 2017 Wiley Periodicals, Inc.

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“…Of the emphysematous subjects one was 36, the others from 51 to 69. The lungs of older people exhibit, because of decreasing elasticity, structural changes similar to those found in emphysematous lungs (1). In agreement with this, with advancing age there is found a not inconsiderable increase of the functional residual capacity, which is caused largely by an increase of the residual volume and only to a lesser extent by an increased expiratory reserve A comparison of Becklake-indices found in different age-groups has been made by Boye (6), who found no significant changes with advancing age.…”

Section: Concerning the Applicability Of T H Ementioning

confidence: 95%

Gas‐mixing in the Lungs A Study of the Clinical Applicability of the So‐called Becklake‐index

Petersen

1963

Journal of Internal Medicine

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The Morphological Spectrum of Aging and Emphysematous Lungs

Cited by 22 publications

References 17 publications

Fibrous Network of the Lung and its Change with Age

Fibrous Network of the Lung and its Change with Age

Extracellular Assembly of the Elastin Cable Line Element in the Developing Lung

Gas‐mixing in the Lungs A Study of the Clinical Applicability of the So‐called Becklake‐index

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