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HIGHLIGHTED TOPICS
Lung Growth and Repair
1Department of Anatomy, Physiology, and Cell Biology, 2Department of Pathology, Microbiology, and Immunology, and 3California National Primate Research Center, School of Veterinary Medicine, University of California, Davis, California 95616
Submitted 5 May 2004 ; accepted in final form 17 August 2004
| ABSTRACT |
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airway smooth muscle; postnatal lung development
With lung maturation, lung function and airway reactivity change. Examples include the rate of emptying during forced expiration decreasing during infancy (31) and children's airways being more reactive to methylcholine and histamine than adult airways (32). Smooth muscle has the potential to modulate airway function and reactivity, and this ability is most likely dependent on the amount, location, orientation, contractile properties, and length-tension relationship of the smooth muscle (36). Airway smooth muscle is present in the fetus and undergoes significant changes as part of pre- and postnatal lung development (5, 30). This study was designed to define the organizational changes in airway smooth muscle during postnatal morphogenesis because the etiology of allergic asthma is now thought be a combination of genetics, the environment, and development (16). We compared smooth muscle bundle size, abundance, and orientation in infant monkeys during early postnatal lung development (5 days and 1, 2, 3, and 6 mo of age). The most distal three generations of nonalveolarized bronchioles and the most proximal two generations of respiratory bronchioles in nonhuman primates, rhesus monkeys, were examined. These generations were chosen because there is evidence that peripheral airways contribute to asthma (21) and because, in humans, terminal bronchioles are transformed into respiratory bronchioles during postnatal alveolarization (25). Airways in the same lung segment, the caudal portion of the left cranial lobe, were evaluated in each animal to ensure that specimen selection was consistent. To define the pattern of changes in airway size during growth, we compared absolute length and diameter of the same airway generation (the bronchiole immediately proximal to the terminal bronchiole) in each animal.
| MATERIALS AND METHODS |
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To determine the normal pattern of airway development in the rhesus monkey, three to six infants, housed from birth in chemical, biological, and radiological filtered air, were necropsied at each of the following ages: 5 days old (46 days), 1 mo old (2527 days), 2 mo old (6366 days), 3 mo old (8588 days), and 6 mo old. These time points were chosen because they span a period of rapid lung growth in both the monkey and human (4, 14).
Dissection and tissue evaluation. Monkeys were euthanized with an overdose of pentobarbital sodium after being sedated with Telazol (8 mg/kg im) and anesthetized with Diprivan (0.10.2 mg·kg1·min1 iv), with the dose adjusted as necessary by the attending veterinarian. The monkeys were then necropsied after exsanguination through the posterior vena cava. Body weight was taken at necropsy. The right middle lobe was cannulated separately and fixed by inflation with glutaraldehyde-paraformaldehyde (110%) at 30 cmH2O pressure. After 4 h of fixation under pressure, lung volume was measured by fluid displacement. The left cranial lobe was fixed via the airways through a bronchial cannula with 1% paraformaldehyde in 0.1 M phosphate buffer (pH 7.2) at 30 cmH2O pressure for 4 h. After fixation, the caudal segment of the left cranial lobe was dissected free, and the axial pathway (from segmental bronchus to alveolar ducts) and its distal side branches were exposed by microdissection into a costal and a mediastinal half (26, 27). The number of branches was determined by direct count of all branches beginning at the lobar bronchus and continuing along the axial path to the first proximal respiratory bronchiole. Smooth muscle orientation was defined for the costal half of the airways. Dissected lobes were permeabilized with 0.3% Triton-X 100, washed with 0.1 M PBS, incubated in 0.066 µM Alexa Fluor 568 phalloidin (Molecular Probes, Eugene, OR) for 20 min, and rinsed with PBS. One axial pathway with at least three of its distal side branches in the microdissected lungs of each animal were imaged using laser scanning confocal microscopy (Bio-Rad MRC 1024 ES mounted on an Olympus BX50WI microscope) with long working distance water-immersion objectives as described previously (28, 35). Alexa Fluor 568 phalloidin (excitation 578; emission 600) allowed visualization of airway smooth muscle because it stains filamentous actin, an abundant protein in smooth muscle cells. A smooth muscle bundle was identified as a group of transversely oriented smooth muscle cells stained with phalloidin and separated from each other by large spaces. Images for specific airway sites were collected using a 4x or 10x objective. Final magnification of all images used for measurements was 170x. Images were 2040 µm apart in the z direction and had a depth of focus of 20 µm. Before analysis, images were tiled together to produce a composite map of the entire distal airway tree (Fig. 1). Airway sites evaluated (Fig. 1A) included the terminal bronchiole (TB); the next two most proximal airway generations, bronchiole 1 generation proximal (PB1) and bronchiole 2 generations proximal (PB2); and the first and second generations of respiratory bronchiole generation distal to the TB (RB1 and RB2, respectively). Respiratory bronchioles were identified during microdissection by the presence of alveolar outpockets. The exact position of the most proximal alveoli (RB1) in each branch path was confirmed on whole mounts using a nuclear dye (4',6'-diamidino-2-phenylindole) to identify epithelial cell distribution, and their positions were marked on the composite maps. The TB was defined as the airway generation proximal to RB1.
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) from perpendicular to the axis of the airway segment (Fig. 1B). Zero degrees was perpendicular to the long axis of the airway, and 90° was parallel to the long axis.
was measured for each smooth muscle bundle. Bundle angle mean and standard deviation were also calculated. Bundle abundance and profile size were determined by defining the boundaries of each airway segment on composite images. Three linear probes, oriented parallel to the airway axis, were superimposed over the image, and the number of intercepts of the probes with smooth muscle bundles was counted. Number per unit length of airway was calculated by dividing the total number of intercepts by the total length of the probes. Relative smooth muscle abundance was calculated as the number of smooth muscle bundles per 100 µm of airway length. The average size of each bundle was estimated as the mean of the absolute values for the length of the probe covering each bundle. Bundle size was standardized to airway diameter size. The diameter of each airway was determined from direct measurement of airway maximum width, and the radius was calculated as width divided by two. The length of airway generation PB1 (the bronchiole proximal to the TB) was determined as the absolute distance, parallel to the long axis, between the branch points proximal and distal to it, using images of both halves of the airway to define the exact branch point. The number of smooth muscle bundles was counted for this airway generation as well.
Statistics.
All data are expressed as means ± SD. Differences between age groups and airway levels were determined by one-way ANOVA (SAS, SAS Institute, Cary, NC). Bundle size in relation to airway size was compared by regression analysis. Differences in slope and regression coefficient were compared between age groups (37). Distribution of smooth muscle bundle orientation was compared with 6-mo-old animals by
2 analysis (SAS, SAS Institute). P < 0.05 was considered statistically significant.
| RESULTS |
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) (see Fig. 1B). Values of
were tallied into four categories: 09.99°, 1019.99°, 2029.99°, and
30°. Categories were based on a study of smooth muscle orientation in the intraparenchymal airways of the cat and human by Lei et al. (22). There was a wide variation in the distribution of
for smooth muscle bundles between distal generations and in the same airway generation between animals of the same and different ages (Fig. 6). There was a trend at 5 days and 1 mo for respiratory bronchioles to have a greater mean smooth muscle bundle
than proximal bronchioles. At 5 days of age, the mean smooth muscle bundle
was 9.8 ± 8.8° for PB2, 8.8 ± 8.2° for PB1, 10.3 ± 9.5° for TB, 11.5 ± 11.2° for RB1, and 11.0 ± 11.8° for RB2. At 1 mo of age, the mean
was 8.3 ± 7.5° for PB2, 8.7 ± 7.2° for PB1, 6.4 ± 5.4° for TB, 9.9 ± 7.9° for RB1, and 14.6 ± 9.3° for RB2.
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1.7-fold greater than at 1 mo of age (Fig. 2B). The number of intrapulmonary airway branches in the axial pathway of the left cranial lobe averaged 13, unchanged from the earlier time points (Fig. 3A). On the other hand, the length of PB1 increased between 1 and 2 mo (Fig. 3B). Length then remained unchanged from 2 to 3 mo. In fact, the length of PB1 of 3-mo-old animals was significantly greater than 5-day-old and 1-mo-old animals (Fig. 3B). At 2 mo of age, the diameter of PB1 in infant animals was significantly decreased compared with the diameter at 3 mo of age (Fig. 3C). However, the estimated surface area of PB1 continued to enlarge with increasing age and length: the surface area was 2,053,185 µm2 at 2 mo and 3,178,395 µm2 at 3 mo (Fig. 4). Furthermore, the number of smooth muscle bundles around PB1 was increased at 2 and 3 mo compared with 5 and 1 mo (Fig. 3D). When the size of smooth muscle bundles in the distal bronchioles was compared between ages, there was no difference in bundle size for the first 3 mo of life (Table 1). However, 2-mo-old animals had significantly smaller bundles in the respiratory bronchioles compared with the proximal bronchioles (Table 1). The linear relationship between increasing airway size and increasing bundle size was retained at 2 and 3 mo of age (Fig. 5). However, with increasing age (at 3 mo), bundle size decreased in relation to airway size. The greatest change was in proximal bronchioles (largest radius). The relative abundance of smooth muscle bundles did not change in the five most distal bronchioles of 2- and 3-mo-old animals and was similar to 5-day-old and 1-mo-old animals (Table 2). However, 2-mo-old animals had significantly greater abundance in RB1 compared with PB2. The distribution of smooth muscle bundle
varied between distal generations and in the same airway generation between animals of the same and different ages (Fig. 6). At 2 mo of age, the mean smooth muscle bundle
was 9.0 ± 8.3° for PB2, 10.9 ± 8.8° for PB1, 12.6 ± 11.4° for TB, 10.7 ± 9.2° for RB1, and 10.1 ± 7.3° for RB2. At 3 mo of age, there was a trend for respiratory bronchioles to have a greater mean
than more proximal bronchioles. The mean smooth muscle bundle
was 9.4 ± 8.4° for PB2, 9.6 ± 8.2° for PB1, 9.3 ± 6.8° for TB, 10.5 ± 7.2° for RB1, and 14.0 ± 14.5° for RB2.
6 mo of age.
By 6 mo of age, the juvenile monkeys had significant changes in overall growth of the airways and smooth muscle compared with all other time points. Body weight increased threefold in 6-mo-old animals compared with 5-day-old and 1-mo old animals (P < 0.05) (Fig. 2A). Fixed lung volume of the right middle lobe was twofold greater in 6-mo-old animals compared with 5-day-old animals (P < 0.05) (Fig. 2B). The number of intrapulmonary airway branches in the axial pathway of the left cranial lobe from the lobar bronchus to the terminal and respiratory bronchioles still averaged 13 generations (Fig. 3A). PB1 grew in length between 3 and 6 mo of age (Fig. 3B). The length of this airway more than doubled between 5 days and 6 mo (P < 0.05). Airway diameter decreased early during postnatal growth and then increased by greater than one-third between 2 and 6 mo (Fig. 3C). Length and diameter changes resulted in a threefold increase in the total surface area of PB1 between 5 days and 6 mo of age (Fig. 4); the estimated surface area of PB1 at 6 mo of age was 5,090,025 µm2. When adjusted for increases in airway size, the absolute number of bundles in PB1 doubled between 5 days and 6 mo of age (P < 0.05) (Fig. 3D). This increase was directly correlated to changes in airway length but not in diameter. Bundle size for a particular airway generation did not change significantly with increasing age in any of the airway generations evaluated (Table 1). However, 6-mo-old animals had significantly smaller bundles in RB2 compared with the PB2 (Table 1). The linear relationship between increasing airway size and increasing bundle size was retained at 6 mo of age (Fig. 5), but animals had significantly smaller bundle size in relation to airway size compared with all ages, especially in the larger bronchioles. The relative abundance of smooth muscle bundles was similar in the five most distal bronchioles of 6-mo-old animals (Table 2). Nevertheless, the abundance in respiratory bronchioles at 6 mo of age was significantly smaller compared with the abundance in respiratory bronchioles at 1 and 2 mo of age. The distribution of smooth muscle bundle
(Fig. 6) was significantly changed in the smaller bronchioles at 6 mo of age compared with earlier time points: distributional differences were found in the TB (at 1 mo), RB1 (at 1, 2, and 3 mo), and RB2 (at 5 days and 2 mo). Similar to prior ages, the respiratory bronchioles had a greater mean
than more proximal bronchioles at 6 mo of age. The mean smooth muscle bundle
was 10.3 ± 9.4° for PB2, 9.3 ± 8.1° for PB1, 9.7 ± 8.0° for TB, 15.2 ± 12.6° for RB1, and 13.3 ± 10.6° for RB2.
| DISCUSSION |
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We evaluated smooth muscle bundles in three-dimensional samples rather than two-dimensional sections, which facilitated evaluation of three parameters: 1) the size of individual bundles, 2) the number of bundles per unit airway length, and 3) the orientation of bundles. These parameters were compared on the basis of airway generation, airway size, and age. We conclude that smooth muscle undergoes marked organizational changes as the airways grow. Distal airway maturation during the first 6 mo after birth involved more than doubling in length, increasing one-third in diameter, and increasing almost threefold in total surface area. During this time, relative smooth muscle abundance was constant regardless of airway generation or age. Because of the intrinsic variability in airway diameter of the same airway generation, we evaluated smooth muscle bundle size using two methods: 1) by airway generation and 2) in relation to airway size (diameter). When comparisons were done on an airway generation basis, we found that smooth muscle bundle size was greater in proximal bronchioles than respiratory bronchioles and that it did not change with age. However, when comparisons were done on an airway size basis, we found that there was a positive correlation between airway size and smooth muscle size at all ages. Yet, relative bundle size decreased in proportion to airway size as the animals aged. The distribution of smooth muscle bundle orientation changed with age in each airway generation, and there were significant changes in the terminal and respiratory bronchioles.
Previous studies have suggested that there is an airway level-specific heterogeneity in smooth muscle abundance that might be altered by a number of factors, including development (18). To ensure that we were comparing the same airway generations in different-aged animals, we used carefully defined specimens (26, 27). We identified the most distal nonalveolarized bronchiole by its junction with alveolarized (respiratory) bronchioles and established its position within the airway tree on the basis of the number of branch points down the axial path between this junction and the lobar bronchus. To further ensure that specimen selection did not bias the study, all of the airways were evaluated from the same portion of the same lobe in all animals. To avoid the potential problems of determining airway size produced by variable states of contractility during fixation, we used a standard fixation and relied on measurements of internal dimension identified by previous studies of smooth muscle function as a reliable measurement of airway size (19). This approach to evaluation allowed us to compare airways of different sizes with known generations and used the analytic approach previously employed to establish whether increases in smooth muscle abundance, or mass, may be contributing to airway reactivity in distal airways (8, 11, 33). We have established that the development of the smooth muscle in the airways differs depending on position within the airway tree and age.
The smooth muscle bundles in the distal airways of infant rhesus monkeys had a wide range of orientation, on the basis of
, which changed with airway generation and age. Our laboratory has previously found an equally wide variation in orientation in older monkeys and in adult rats and rabbits (29), and other studies using adult animals have documented this as well (9, 22). The most significant changes in the distribution of smooth muscle orientation were found in the terminal and respiratory bronchioles of rhesus monkeys as they aged. Perhaps these changes reflect ongoing alveolarization. By 6 mo of age, rhesus monkeys had an average
that ranged from 9 to 15° depending on airway generation. This is relatively similar to the overall average (13°) calculated for adult humans and cats (9, 22).
Theoretical estimates suggest a strong impact of smooth muscle orientation (i.e., helical pitch) on airway contractility (2). The closer the orientation of a bundle to perpendicular (smaller
), the greater degree of airway constriction for the amount of smooth muscle shortening. As the percentage of the bundles with greater helical pitch (higher
) increases, their contribution to the effective force of the entire smooth muscle bundle population operating on an individual airway segment decreases. The inverse is true when more of the bundles are oriented closer to perpendicular (lower
). Thus airway resistance would be affected by smooth muscle orientation. Increases in airway wall stiffness expected from the wall thickening in airways of asthmatic individuals could alter the effect of bundle orientation on airway contractility, depending on the degree of airway wall stiffness and the directionality of the stiffness (2). Longitudinally stiff airways would be more responsive to smooth muscle bundles at smaller deviations from perpendicular, whereas circumferentially stiff airways would be more responsive to bundles at greater angles. Our study suggests that the extent of airway contractility and airway resistance in relation to smooth muscle bundle constriction varies greatly with postnatal age because bundle orientation changes during this time.
In summary, our study shows that postnatal maturation of conducting airways during growth seems to be regulated by at least two processes that modulate smooth muscle morphogenesis: one that establishes smooth muscle mass by regulating bundle size and abundance and the other that establishes bundle orientation. Distal airways do not appear to increase in size uniformly in all dimensions as the lung grows, which may contribute to the modulation of these two morphogenic processes. Furthermore, the timing and pattern of these processes in distal bronchioles are unique to the airway level and dependent on whether the airway undergoes alveolarization to become respiratory bronchioles. As a consequence, the size of smooth muscle bundles is greatest in more proximal, nonalveolarized bronchioles and decreases with age during postnatal growth. Whereas potential regulatory processes that drive smooth muscle morphogenesis are poorly understood, especially under conditions of early postnatal exposure to allergens, our study defines the pattern and time course of events and identifies potential targets for disruption.
| GRANTS |
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| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
| REFERENCES |
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