pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2008-0-3-48-53pulmo-1803Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESАспекты патогенеза эмфиземы легких у больных ХОБЛSome pathogenic aspects of pulmonary emphysema in COPD patientsАверьяновА. В.AveryanovA. V.

Москва

СамсоноваМ. В.SamsonovaM. V.

Москва

ЧерняевА. Л.ChernyaevA. L.

Москва

ЧучалинА. Г.ChuchalinA. G.

Москва

ПоливановаА. Э.PolivanovaA. E.

Москва

НиколаевГ. В.NikolaevG. V.

Санкт-Петербург

ПерепечинВ. И.PerepechinV. I.

Москва

ПоливановГ. Э.PolivanovG. E.

Москва

ДвораковскаяИ. В.DvorakovskayaI. V.

Санкт-Петербург

ФГУ НИИ пульмонологии ФМБА РоссииRussian FederationИнститут высоких медицинских технологий СПГУRussian FederationФГУ НИИ хирургии им. А.В.Вишневского РосмедтехнологийRussian FederationНИИ пульмонологии СПГМУ им. И.П.Павлова РосздраваRussian Federation200828062008034853Copyright © Аверьянов А.В., Самсонова М.В., Черняев А.Л., Чучалин А.Г., Поливанова А.Э., Николаев Г.В., Перепечин В.И., Поливанов Г.Э., Двораковская И.В., 20082008Аверьянов А.В., Самсонова М.В., Черняев А.Л., Чучалин А.Г., Поливанова А.Э., Николаев Г.В., Перепечин В.И., Поливанов Г.Э., Двораковская И.В.Averyanov A.V., Samsonova M.V., Chernyaev A.L., Chuchalin A.G., Polivanova A.E., Nikolaev G.V., Perepechin V.I., Polivanov G.E., Dvorakovskaya I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/1803

Проведено патогистологическое и иммуногистохимическое исследование ткани легких 9 больных ХОБЛ, подвергшихся хирургической редукции объема легких. В качестве сравнения использовались кусочки легких умерших насильственной смертью без патологии легких и сердца. Изучалась тканевая экспрессия фактора роста эндотелия (ЭФР), матриксной металлопротеиназы 9-го типа, тканевого ингибитора металлопротеиназ 1-го типа (ТИМП-1), трансформирующего фактора роста β-1 (ТФР β-1). Установлено, что для больных тяжелой эмфиземой легких характерны очаговый интерстициальный фиброз, инфильтрация межальвеолярных перегородок альвеолярными макрофагами и лимфоцитами, изменения сосудов с гипертрофией медии, пролиферацией интимы, мускуляризацией артериол. В ткани легких больных тяжелой эмфиземой наблюдалась достоверно более высокая экспрессия ЭФР и ТИМП-1, чем в группе контроля, что подтверждает существование механизмов компенсации деструктивных процессов паренхимы легких. Обнаружены сильные прямые корреляционные связи между экспрессией ЭФР с ТФР β-1 и ЭФР с ТИМП-1, свидетельствующие о зависимости процессов ангиогенеза, протеолиза и фиброгенеза в патогенезе эмфиземы.

Histological and immunohistochemical investigations of lung tissue specimens were performed in 9 patients with COPD underwent lung volume reduction surgery. Lung tissue specimens of died persons without lung and heart pathology were as controls. Tissue expressions of endothelial growth factor (EGF), type 9 matrix metalloproteinase, type 1 matrix metalloproteinase (TIMP-1) tissue inhibitor, and transforming growth factor β1 (TGF β-1) have been studied. Patents with severe emphysema typically had focal interstitial fibrosis, interalveolar septa infiltrated with interstitial macrophages and lymphocytes, hypertrophy of media and proliferation of intima in the vascular wall, and arteriolar muscularization. There was significantly higher expression of EGF and TIMM-1 in the lung tissue of these patients compared with controls; this could confirm the presence of compensatory mechanisms of lung parenchyma destruction. Strong correlations were found between expression of EGF and TGF β-1, EGF and TIMP-1 which demonstrated a relationship between angiogenesis, proteolysis and fibrogenesis in development of emphysema.

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The authors declare that there are no conflicts of interest present.