Smoking cessation and bronchial epithelial remodelling in COPD: a cross-sectional study

Therese S. Lapperre*, Jacob K. Sont, Annemarie van Schadewijk, Margot Gosman, Ingeborg M. Bajema, Wim Timens, Thais Mauad, Pieter S. Hiemstra, H. F. Kauffman, H. M. Boezen, D. F. Jansen, J. Vonk, M. D. W. Barentsen, M. Zeinstra-Smit, A. J. Luteijn, T. van der Molen, G. ter Veen, N. H. T. ten Hacken, H. A. M. Kerstjens, M. S. van MaarenD. S. Postma, C. A. Veltman, A. Verbokkem, I. Verhage, H. K. Vink-Kloosters, J. B. Snoeck-Stroband, H. Thiadens, J. K. Sont, I. Bajema, J. Gast-Strookman, P. S. Hiemstra, K. Janssen, T. S. Lapperre, K. F. Rabe, A. van Schadewijk, J. A. Schrumpf, J. Smit-Bakker, J. Stolk, A. C. J. A. Tire, H. van der Veen, M. M. E. Wijffels, L. N. A. Willems, P. J. Sterk, T. Mauad, GLUCOLD Study Grp, D. de Reus

*Corresponding author for this work

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Abstract

Background: Chronic Obstructive Pulmonary Disease ( COPD) is associated with bronchial epithelial changes, including squamous cell metaplasia and goblet cell hyperplasia. These features are partially attributed to activation of the epidermal growth factor receptor ( EGFR). Whereas smoking cessation reduces respiratory symptoms and lung function decline in COPD, inflammation persists. We determined epithelial proliferation and composition in bronchial biopsies from current and ex-smokers with COPD, and its relation to duration of smoking cessation.

Methods: 114 COPD patients were studied cross-sectionally: 99 males/15 females, age 62 +/- 8 years, median 42 pack-years, no corticosteroids, current (n = 72) or ex-smokers ( n = 42, median cessation duration 3.5 years), postbronchodilator FEV 63 +/- 9% predicted. Squamous cell metaplasia (%), goblet cell ( PAS/Alcian Blue(+)) area (%), proliferating (Ki- 67(+)) cell numbers (/mm basement membrane), and EGFR expression (%) were measured in intact epithelium of bronchial biopsies.

Results: Ex-smokers with COPD had significantly less epithelial squamous cell metaplasia, proliferating cell numbers, and a trend towards reduced goblet cell area than current smokers with COPD ( p = 0.025, p = 0.001, p = 0.081, respectively), but no significant difference in EGFR expression. Epithelial features were not different between short-term quitters (

Conclusion: Ex-smokers with COPD had less bronchial epithelial remodelling than current smokers, which was only observed after long-term smoking cessation (>3.5 years).

Original languageEnglish
Article number85
Number of pages9
JournalRespiratory Research
Volume8
DOIs
Publication statusPublished - 26-Nov-2007

Keywords

  • OBSTRUCTIVE PULMONARY-DISEASE
  • GROWTH-FACTOR RECEPTOR
  • CHRONIC MUCUS HYPERSECRETION
  • HUMAN NEUTROPHIL DEFENSINS
  • AIR-FLOW OBSTRUCTION
  • CURRENT SMOKERS
  • LUNG HEALTH
  • PERIPHERAL AIRWAYS
  • GOBLET CELL
  • EX-SMOKERS

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