PT - JOURNAL ARTICLE AU - Stephanie Everaerts AU - John E. McDonough AU - Stijn E. Verleden AU - Iván Josipovic AU - Matthieu Boone AU - Adriana Dubbeldam AU - Carolien Mathyssen AU - Jef Serré AU - Lieven J. Dupont AU - Ghislaine Gayan-Ramirez AU - Johny Verschakelen AU - James C. Hogg AU - Geert M. Verleden AU - Bart M. Vanaudenaerde AU - Wim Janssens TI - Airway morphometry in COPD with bronchiectasis: a view on all airway generations AID - 10.1183/13993003.02166-2018 DP - 2019 Jan 01 TA - European Respiratory Journal PG - 1802166 4099 - http://erj.ersjournals.com/content/early/2019/08/07/13993003.02166-2018.short 4100 - http://erj.ersjournals.com/content/early/2019/08/07/13993003.02166-2018.full AB - The pathophysiological processes underlying bronchiectasis in COPD are not understood. In COPD, both small and large airways are progressively lost. It is currently not known to what extent the different airway generations of patients with COPD and bronchiectasis are involved.COPD explant lungs with bronchiectasis were compared to COPD explant lungs without bronchiectasis and unused donor lungs as controls. In order to investigate all airway generations, a multimodal imaging approach using different resolutions was conducted. Per group, 5 lungs were frozen (n=15), underwent CT imaging for large airway evaluation with 4 tissue cores per lung imaged for terminal bronchioles measurements. Two additional lungs per group (n=6) were air-dried for lobar microCT images that allow airway segmentation and 3D quantification of the complete airway tree.COPD lungs with bronchiectasis had significantly more airways compared to COPD lungs without bronchiectasis (p<0.001), with large airway numbers similar to control lungs. This difference was present in both upper and lower lobes. Lack of tapering was present (p=0.010) and larger diameters were demonstrated in lower lobes with bronchiectasis (p=0.010). MicroCT analysis of tissue cores showed similar reductions of tissue percentage, surface density and number of terminal bronchioles in both COPD groups compared to control lungs.Although terminal bronchioles were equally reduced in COPD lungs with and without bronchiectasis, significantly more large and small airways were found in COPD lungs with bronchiectasis.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Everaerts reports grants from FWO, Flemish research fund, during the conduct of the study.Conflict of interest: Dr. McDonough has nothing to disclose.Conflict of interest: Dr. Verleden has nothing to disclose.Conflict of interest: Dr. Josipovic has nothing to disclose.Conflict of interest: Dr. Boone has nothing to disclose.Conflict of interest: Dr. Dubbeldam has nothing to disclose.Conflict of interest: Ms. Mathyssen has nothing to disclose.Conflict of interest: Dr. Serré has nothing to disclose.Conflict of interest: Dr. Dupont has nothing to disclose.Conflict of interest: Dr. Gayan-Ramirez has nothing to disclose.Conflict of interest: Dr. Verschakelen has nothing to disclose.Conflict of interest: Dr. Hogg has nothing to disclose.Conflict of interest: Dr. Verleden has nothing to disclose.Conflict of interest: Dr. Vanaudenaerde has nothing to disclose.Conflict of interest: Dr. Janssens reports grants from AstraZeneca, Chiesi, Boehringer Ingelheim, outside the submitted work.