The Clinical Research Of Apoptosis In Patients With Chronic Obstructive Pulmonary Disease And Airway Remodeling

Objective:To investigate the role of bax expression in apoptosis versus proliferation activities of bronchi epithelial cells,alveolar wall cells,bronchi smooth muscle cells inpatients with chronic obstructive pulmonary disease(COPD) and airway remodeling.Methods:Lung specimens from patients without COPD(non-COPD group,n=15),and patients with with COPD(COPD group,n=15) were investigated.The remodeling of airway were observed under microscope and the changes of morphology were analysed by computer-based image analysis system.The proliferation of bronchi epithelial cells,alveolar wall cells,bronchi smooth muscle cells were detected by proliferating cell nuclear antigen(PCNA) with immunohistochemical technique,and TUNEL(terminal deoxynucleotidyl transferase—mediated d-UTP nick end labeling) techniques were used for the detection of the apoptosis.The expression of,bax protein was detected immunohistochemically.Results:In COPD group,the walls were thicker and the lumens were narrower than that of the non-COPD group.Both the ratio of the thickness of the wall to the external diameter of the bronchi (WT%) and the ratio of the area of the wall to that of the bronchi(WA%)were calculated by the computer-based image analysis systym.In the COPD group the WT%and WA%[(10.3±2.1)%, (17.8±2.7)%]were higher than those of the non-COPD group[(6.2±1.4)%,(10.1±1.8) %](all P＜0.01),The percentage of apoptotic cells of bronchi epithelial cells,alveolar wall cells and bronchi smooth muscle cells were,[(43.1±4.1)%(37.4±4.5)%(3.9±1.6)%]in COPD group; as compared with Non-COPD group[(10.6±2.2)%(8.1±1.4)%(5.6±1.2)%].The ratio of apoptotic index(A I) of bronchi epithelial cells,alveolar wall cells are significantly higher than Non-COPD group(all P＜0.01),The ratio of apoptotic index(A I) of bronchi smooth muscle cells is significantly lower than Non-COPD group(P＜0.01).The percentage of proliferative cells of bronchi epithelial cells,alveolar wall cells and bronchi smooth muscle cells were[(34.9±4.4)%(31.1±4.3)%(20.9±2.6)%]in COPD group;as compared with Non-COPD group[(11.5±2.2)%(9.2±2.3)%(5.4±1.4)%],The numbers of proliferating cells were significantly higher in the COPD group(all P＜0.01).The ratio of proliferative index(P I)/apoptotic index(A I) of the pulmonary tissue cells were also different.The ratio of P I/A I of bronchi epithelial cells,alveolar wall cells were[(0.81±0.05)% (0.80±0.10)%]in COPD group,which were much lower than in the Non-COPD group[(1.08±0.07) %(1.10±0.20)%](all P＜0.05).The ratio of P I/A I of bronchi smooth muscle cells in the COPD groups(6.27±2.38)%was significantly higher than in the Non-COPD group(0.98±0.13)% (P＜0.01)..The percentage of bax cells in the pulmonary tissue were also different The percentage of bax cells of bronchi epithelial cells,alveolar wall cells were[(16.8±2.4)%(10.9±1.8)%]in COPD group;which were much higher in Non-COPD group[(6.3±1.3)%(5.3±1.4)%],(all P＜0.01) The percentage of bax cells of bronchi smooth muscle cells in the COPD groups(1.6±0.9)%was significantly lower than in the Non-COPD group(5.8±1.2)%(P＜0.01)Conclusion:Both proliferation and apoptosis were found in COPD group,and in Non-COPD group.The changes of proliferative cells were prevail in bronchi smooth muscle cells while the changes of apoptotic cells were prevail in bronchi epithelial cells and alveolar wall cells..The imbalance of apoptosis and proliferation of pulmonary tissue in patients with COPD might contribute to the pathogenesis and airway remodeling of COPD.The activity of bax,may play a regulation role in apoptosis of COPD...