Abstract: Poster Presentations |


Dilip Nataraj, MD*; Hikaru Sugimoto, MD; Rajan Mariappan, MD; Armin Ernst, MD; Adnan Majid, MD; Malcolm M. DeCamp, MD; Sidharta P. Gangadharan, MD; Michael Kent, MD; Felix J. Herth, MD; Raghu Kalluri, MD
Author and Funding Information

Beth Israel Deaconess Medical Center, Boston, MA


Chest. 2009;136(4_MeetingAbstracts):80S. doi:10.1378/chest.136.4_MeetingAbstracts.80S
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PURPOSE:  Tracheobronchomalacia (TBM) can be a debilitating disease associated with significant morbidity. Current therapies involve invasive procedures. This study is being conducted to determine whether a fibrotic process is present in this disease and if epithelial mesenchymal transition is a mechanism.

METHODS:  Endobronchial biopsies from 6 patients with severe TBM, who have not had any intervention, underwent immunohistochemical staining for extracellular matrix components (Collagen I, III, and IV) and markers of fibrosis, namely Fibroblast Specific Protein 1 (FSP-1) and alpha Smooth Muscle Actin (αSMA). These were compared with biopsies from 3 patients with no known airway disease. Biopsies were taken from the anterior tracheal wall (ATW), tracheal posterior membrane (TPM), and right mainstem anterior wall (RMA).

RESULTS:  4/4 biopsies from the ATW, 2/2 biopsies from the TPM, and 3/4 biopsies from the RMA displayed increased Collagen I expression. 4/5 biopsies from the ATW, 1/1 biopsies from the TPM, and 3/4 biopsies from the RMA demonstrated increased Collagen III expression. 0/4 biopsies from the ATW, 1/2 biopsies from the TPM, and 1/3 biopsies from the RMA revealed increased Collagen IV expression. 0/5 biopsies from the ATW, 0/2 biopsies from the TPM, and 0/4 biopsies from the RMA displayed increased FSP-1 expression. 0/5 biopsies from the ATW, 2/2 biopsies from the TPM, and 1/4 biopsies from the RMA demonstrated increased αSMA expression.

CONCLUSION:  TBM may result from a fibrotic process as evidenced by the increases in Collagens I and III but not IV, as noted in pulmonary fibrosis also. The mechanism is unclear at this time, but may involve epithelial mesenchymal transition.

CLINICAL IMPLICATIONS:  As more knowledge is gained regarding the underlying histopathology of this disease, more effective and less invasive therapies may be developed.

DISCLOSURE:  Dilip Nataraj, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

12:45 PM - 2:00 PM




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