Relationship between immunohistochemical assessment of bronchial mucosa microvascularization and clinical stage in asthma

Vol. 53 No. 3 Suppl., 2012
This supplement was not sponsored by Outside Organizations.


Adriana Grigoras, Irina-Draga Caruntu, C. C. Grigoras, T. Mihaescu, Cornelia Amalinei

Although hardly ever used in current practice, fibrobronchoscopy may provide interesting histopathological-clinical correlations in patients diagnosed with different stages of evolutive asthma. The aim of the study was to evaluate the correlation between semi-quantitative microvascularization features and the asthma severity assessed according to the GINA classification 2006. Our study group consisted in 21 patients diagnosed with asthma of different stages of severity and two-control patients investigated by fibrobronchoscopy with associated biopsy. The tissue fragments underwent standard processing procedures for the immunohistochemical exam, using CD34 as microvascularization marker. The semi-quantitative analysis was based on the "hot spot" method and on a score system that corresponds to the microvessels density. The statistical analysis of the correspondence between CD34 score and clinical parameters was performed using the SPSS 17 software, applying non-parametric correlation tests. The CD34 evaluation showed an increase in blood vessels count in all asthmatic patients in comparison to the control group and a close correlation with the asthma severity, reflected by the FEV1 values. The statistical analysis showed an inverse correlation between FEV1 [%] values and CD34 expression (r=-0.93, p<<0.01). Our data concur to other research reports, supporting the hypothesis that angiogenesis initially facilitates the edema development and later on appears to be involved in the bronchial wall thickening, as a component of the chronic inflammatory response, with concomitant distensibility reduction. The bronchial mucosa microvascularization evaluation opens new perspectives for advanced therapies, with beneficial effects for asthmatic patients' life quality.

Corresponding author: Irina-Draga Caruntu, Professor, MD, PhD; e-mail:

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Ofelia Jercan, M. Penescu, Diana Maria Trasca

Introduction: Several studies have shown the prognostic value of markers detecting interstitial infiltration, epithelial-mesenchymal transition (EMT) and tubulo-interstitial damage in chronic kidney disease evolution. Aim of our investigation was to further evaluate the pathological correlation of such parameters in a population with chronic kidney disease in early stages. Materials, Methods and Results: In a population of 16 patients, with a prior diagnosis of chronic kidney disease in early stages, that underwent a biopsy procedure for clinical indication, there were evaluated the expression in kidney tissue of mesenchymal, epithelial and proliferation markers. Material remaining after routine light microscopy and immunofluorescence was stained for mesenchymal markers such as vimentin, epithelial markers such as cytokeratin and E-cadherin. Quantitative evaluation was conducted by electronic image analysis on consecutive low power fields, avoiding glomeruli, and estimated as percentage of the total area. The clinical and biochemical characteristics evaluated during the hospitalization period showed the prevalence of multiple cardiovascular risk factors such as: arterial hypertension (68%), abnormal blood lipid levels (32%), obesity (27%), diabetes (19%). The histopathological characteristics of chronic kidney dysfunction was related with higher expression of mesenchymal markers (p<0.001) and a decrease expression of epithelial markers (p=0.003). Conclusions: The interrelation of epithelial and mesenchymal tubulo-interstitial markers was demonstrated even in early stages of chronic kidney dysfunction.

Corresponding author: Ofelia Jercan, MD, PhD student; e-mail:

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