CYSTIC FIBROSIS

Structural changes to airway smooth muscle in cystic fibrosis

S R Hays, R E Ferrando, R Carter, H H Wong, P G Woodruff

Division of Pulmonary and Critical Care Medicine, Department of Medicine and the Cardiovascular Research Institute, University of California San Francisco, USA

Correspondence to:
Correspondence to:
Dr P G Woodruff
Box 0130, Moffitt Hospital, 505 Parnassus Ave, San Francisco, CA 94143, USA; woodruff{at}itsa.ucsf.edu

Background: Chronic airway obstruction is characteristic of cystic fibrosis (CF) but there are few studies of airway smooth muscle remodelling in CF.

Methods: Airway smooth muscle content and mean airway smooth muscle cell size were measured by applying design-based stereology to bronchoscopic biopsy specimens obtained from seven subjects with CF and 15 healthy controls.

Results: The smooth muscle content increased by 63% in subjects with CF (mean (SD) 0.173 (0.08) v 0.106 (0.042) mm³ smooth muscle/mm³ submucosa, mean difference –0.067; 95% CI –0.12 to –0.013, p = 0.017) but there was no increase in mean cell size (2705 (351) v 2654 (757) µm³, mean difference –51; 95% CI –687 to 585, p = 0.87).

Conclusions: These findings indicate hyperplasia of airway smooth muscle cells without hypertrophy and suggest that accumulation of airway smooth muscle cells may contribute to airway narrowing and bronchial hyperresponsiveness in CF.

Keywords: cystic fibrosis; bronchial hyperresponsiveness; airway smooth muscle

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