Histologic Evidence of Intrapulmonary Anastomoses by Three-Dimensional Reconstruction in Severe Bronchopulmonary Dysplasia

Rationale: Bronchopulmonary dysplasia (BPD) is the chronic lung disease of infancy that occurs in premature infants after oxygen and ventilator therapy for acute respiratory disease at birth. Despite improvement in current therapies, the clinical course of infants with BPD is often characterized by...

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Main Authors: Galambos, Csaba, Sims-Lucas, Sunder, Abman, Steven H.
Format: Artigo
Jezik:Inglês
Izdano: American Thoracic Society 2013
Teme:
Original Research
Online dostop:https://ncbi.nlm.nih.gov/pmc/articles/PMC3960909/
https://ncbi.nlm.nih.gov/pubmed/23987309
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1513/AnnalsATS.201305-124OC
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spelling pubmed-39609092014-10-01 Histologic Evidence of Intrapulmonary Anastomoses by Three-Dimensional Reconstruction in Severe Bronchopulmonary Dysplasia Galambos, Csaba Sims-Lucas, Sunder Abman, Steven H. Ann Am Thorac Soc Original Research Rationale: Bronchopulmonary dysplasia (BPD) is the chronic lung disease of infancy that occurs in premature infants after oxygen and ventilator therapy for acute respiratory disease at birth. Despite improvement in current therapies, the clinical course of infants with BPD is often characterized by marked hypoxemia that can become refractory to therapy. Preacinar anatomic and functional communications between systemic and pulmonary vascular systems has been established in fetal lungs, but whether increased intrapulmonary anastomotic vessels or their failure to regress after birth contributes to hypoxemia in preterm infants with BPD is unknown. Objectives: We sought to find histologic evidence of intrapulmonary anastomotic vessels in lungs of patients who died of severe BPD. Methods: We collected lung tissues from fatal BPD cases and performed histology, immunohistochemistry, and high-precision three-dimensional reconstruction techniques. Measurements and Main Results: We report histologic evidence of intrapulmonary vessels that bridge pulmonary arteries and veins in the distal lungs of infants dying with severe BPD. These prominent vessels appear similar to “misaligned pulmonary veins” described in the lethal form of congenital lung disorder, alveolar capillary dysplasia. Conclusions: We found striking histological evidence of precapillary arteriovenous anastomotic vessels in the lungs of infants with severe bronchopulmonary dysplasia. We propose that persistence or expansion of these vessels after premature birth provides the anatomic basis for intrapulmonary shunt and hypoxemia in neonates with severe bronchopulmonary dysplasia and may play a significant role in the morbidity and mortality of BPD. American Thoracic Society 2013-10 /pmc/articles/PMC3960909/ /pubmed/23987309 http://dx.doi.org/10.1513/AnnalsATS.201305-124OC Text en Copyright © 2013 by the American Thoracic Society
institution US NLM
collection PubMed Central
language Inglês
format Artigo
topic Original Research
spellingShingle Original Research
Galambos, Csaba
Sims-Lucas, Sunder
Abman, Steven H.
Histologic Evidence of Intrapulmonary Anastomoses by Three-Dimensional Reconstruction in Severe Bronchopulmonary Dysplasia
description Rationale: Bronchopulmonary dysplasia (BPD) is the chronic lung disease of infancy that occurs in premature infants after oxygen and ventilator therapy for acute respiratory disease at birth. Despite improvement in current therapies, the clinical course of infants with BPD is often characterized by marked hypoxemia that can become refractory to therapy. Preacinar anatomic and functional communications between systemic and pulmonary vascular systems has been established in fetal lungs, but whether increased intrapulmonary anastomotic vessels or their failure to regress after birth contributes to hypoxemia in preterm infants with BPD is unknown. Objectives: We sought to find histologic evidence of intrapulmonary anastomotic vessels in lungs of patients who died of severe BPD. Methods: We collected lung tissues from fatal BPD cases and performed histology, immunohistochemistry, and high-precision three-dimensional reconstruction techniques. Measurements and Main Results: We report histologic evidence of intrapulmonary vessels that bridge pulmonary arteries and veins in the distal lungs of infants dying with severe BPD. These prominent vessels appear similar to “misaligned pulmonary veins” described in the lethal form of congenital lung disorder, alveolar capillary dysplasia. Conclusions: We found striking histological evidence of precapillary arteriovenous anastomotic vessels in the lungs of infants with severe bronchopulmonary dysplasia. We propose that persistence or expansion of these vessels after premature birth provides the anatomic basis for intrapulmonary shunt and hypoxemia in neonates with severe bronchopulmonary dysplasia and may play a significant role in the morbidity and mortality of BPD.
author Galambos, Csaba
Sims-Lucas, Sunder
Abman, Steven H.
author_facet Galambos, Csaba
Sims-Lucas, Sunder
Abman, Steven H.
author_sort Galambos, Csaba
title Histologic Evidence of Intrapulmonary Anastomoses by Three-Dimensional Reconstruction in Severe Bronchopulmonary Dysplasia
title_short Histologic Evidence of Intrapulmonary Anastomoses by Three-Dimensional Reconstruction in Severe Bronchopulmonary Dysplasia
title_full Histologic Evidence of Intrapulmonary Anastomoses by Three-Dimensional Reconstruction in Severe Bronchopulmonary Dysplasia
title_fullStr Histologic Evidence of Intrapulmonary Anastomoses by Three-Dimensional Reconstruction in Severe Bronchopulmonary Dysplasia
title_full_unstemmed Histologic Evidence of Intrapulmonary Anastomoses by Three-Dimensional Reconstruction in Severe Bronchopulmonary Dysplasia
title_sort histologic evidence of intrapulmonary anastomoses by three-dimensional reconstruction in severe bronchopulmonary dysplasia
publisher American Thoracic Society
publishDate 2013
url https://ncbi.nlm.nih.gov/pmc/articles/PMC3960909/
https://ncbi.nlm.nih.gov/pubmed/23987309
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1513/AnnalsATS.201305-124OC
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