Cardiopulmonary diseases are major causes of death worldwide, but currently recommended strategies for diagnosis and prevention may be outdated because of recent changes in risk factor patterns. The Swedish CArdioPulmonarybioImage Study (SCAPIS) combines the use of new imaging technologies, advances in large‐scale ‘omics’ and epidemiological analyses to extensively characterize a Swedish cohort of 30 000 men and women aged between 50 and 64 years. The information obtained will be used to improve risk prediction of cardiopulmonary diseases and optimize the ability to study disease mechanisms. A comprehensive pilot study in 1111 individuals, which was completed in 2012, demonstrated the feasibility and financial and ethical consequences of SCAPIS. Recruitment to the national, multicentre study has recently started.
Background: Lung mast cells are stereotypically divided into connective tissue (MC TC ) and mucosal (MC T ) mast cells. This study tests the hypothesis that each of these subtypes can be divided further into site-specific populations created by the microenvironment within each anatomical lung compartment. Methods: Surgical resections and bronchial and transbronchial biopsies from non-smoking individuals were obtained to study mast cells under non-inflamed conditions. Morphometric and molecular characteristics of mast cell populations were investigated in multiple lung structures by immunohistochemistry and electron microscopy. Results: MC T and MC TC coexisted in all compartments, with MC T being the prevailing type in bronchi, bronchioles and the alveolar parenchyma and MC TC being more abundant in pulmonary vessels and the pleura. Each of the MC TC and MC T phenotypes could be further differentiated into site-specific populations. MC TC were significantly larger in pulmonary vessels than in small airway walls, while the reverse was observed for MC T . Within each MC TC and MC T population there were also distinct sitespecific expression patterns of the IgE receptor, interleukin-9 receptor, renin, histidine decarboxylase, vascular endothelial growth factor, fibroblast growth factor, 5-lipoxygenase and leukotriene C4 synthase (eg, bronchial MC T consistently expressed more histidine decarboxylase than alveolar MC T ). Renin content was high in vascular MC TC but markedly lower in MC TC in other compartments. For both MC TC and MC T , the IgE receptor was highly expressed in conducting airways but virtually absent in alveolar parenchyma.Conclusions: These findings demonstrate novel sitespecific subpopulations of lung MC TC and MC T at baseline conditions. This observation may have important implications in the future exploration of mast cells in a number of pulmonary diseases.
As COPD progresses to its severe stages, the mast cell populations in the lung undergo changes in density, distribution, and molecular expression. In COPD lungs, these novel histopathological features were found to be correlated to lung function and they may thus have clinical consequences.
Background: The GOLD classification of COPD severity introduces a stage 0 (at risk) comprising individuals with productive cough and normal lung function. The aims of this study were to investigate total mortality risks in GOLD stages 0-4 with special focus on stage 0, and furthermore to assess the influence of symptoms of chronic bronchitis on mortality risks in GOLD stages 1-4.
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