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Bronchoscopic mucosal cryobiopsies as a method for studying airway disease

Hvidtfeldt, Morten ; Pulga, Alexis ; Hostrup, Morten ; Sanden, Caroline LU ; Mori, Michiko LU ; Bornesund, Daisy LU ; Larsen, Klaus R. ; Erjefält, Jonas S. LU and Porsbjerg, Celeste (2019) In Clinical and Experimental Allergy 49(1). p.27-34
Abstract

Background: Investigating disease mechanisms and treatment responses in obstructive airway diseases with invasive sampling are hampered by the small size and mechanical artefacts that conventional forceps biopsies suffer from. Endoscopic cryobiopsies are larger and more intact and are being increasingly used. However, the technique has not yet been explored for obtaining mucosa biopsies. Objective: To investigate differences in size and quality of endobronchial mucosal biopsies obtained with cryotechnique and forceps. Further, to check for eligibility of cryobiopsies to be evaluated with immunohistochemistry and in situ hybridization and to investigate tolerability and safety of the technique. Methods: Endobronchial mucosal biopsies... (More)

Background: Investigating disease mechanisms and treatment responses in obstructive airway diseases with invasive sampling are hampered by the small size and mechanical artefacts that conventional forceps biopsies suffer from. Endoscopic cryobiopsies are larger and more intact and are being increasingly used. However, the technique has not yet been explored for obtaining mucosa biopsies. Objective: To investigate differences in size and quality of endobronchial mucosal biopsies obtained with cryotechnique and forceps. Further, to check for eligibility of cryobiopsies to be evaluated with immunohistochemistry and in situ hybridization and to investigate tolerability and safety of the technique. Methods: Endobronchial mucosal biopsies were obtained with cryotechnique and forceps from patients with haemoptysis undergoing bronchoscopy and evaluated by quantitative morphometry, automated immunohistochemistry and in situ hybridization. Results: A total of 40 biopsies were obtained from 10 patients. Cross-sectional areas were threefold larger in cryobiopsies (median: 3.08 mm2 (IQR: 1.79) vs 1.03 mm2 (IQR: 1.10), P < 0.001). Stretches of intact epithelium were 8-fold longer (median: 4.61 mm (IQR: 4.50) vs 0.55 mm (IQR: 1.23), P = 0.001). Content of glands (median: 0.095 mm2 (IQR: 0.30) vs 0.00 mm2 (IQR: 0.01), P = 0.002) and airway smooth muscle (median: 0.25 mm2 (IQR: 0.30) vs 0.060 mm2 (IQR: 0.11), P = 0.02) was higher in the cryobiopsies compared with forceps biopsies. Further, the cryobiopsies had well-preserved protein antigens and mRNA. Mild to moderate bleeding was the only complication observed. Conclusion and clinical relevance: By yielding significantly larger and more intact biopsies, the cryotechnique represents a valuable new research tool to explore the bronchi in airway disease. Ultimately with the potential to create better understanding of underlying disease mechanisms and improvement of treatments.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical and Experimental Allergy
volume
49
issue
1
pages
27 - 34
publisher
Wiley
external identifiers
  • scopus:85054798594
  • pmid:30244522
ISSN
0954-7894
DOI
10.1111/cea.13281
language
English
LU publication?
yes
id
3ccde29b-d72a-473a-8ad7-bb95bf927271
date added to LUP
2018-11-13 09:49:58
date last changed
2024-03-02 11:36:28
@article{3ccde29b-d72a-473a-8ad7-bb95bf927271,
  abstract     = {{<p>Background: Investigating disease mechanisms and treatment responses in obstructive airway diseases with invasive sampling are hampered by the small size and mechanical artefacts that conventional forceps biopsies suffer from. Endoscopic cryobiopsies are larger and more intact and are being increasingly used. However, the technique has not yet been explored for obtaining mucosa biopsies. Objective: To investigate differences in size and quality of endobronchial mucosal biopsies obtained with cryotechnique and forceps. Further, to check for eligibility of cryobiopsies to be evaluated with immunohistochemistry and in situ hybridization and to investigate tolerability and safety of the technique. Methods: Endobronchial mucosal biopsies were obtained with cryotechnique and forceps from patients with haemoptysis undergoing bronchoscopy and evaluated by quantitative morphometry, automated immunohistochemistry and in situ hybridization. Results: A total of 40 biopsies were obtained from 10 patients. Cross-sectional areas were threefold larger in cryobiopsies (median: 3.08 mm<sup>2</sup> (IQR: 1.79) vs 1.03 mm<sup>2</sup> (IQR: 1.10), P &lt; 0.001). Stretches of intact epithelium were 8-fold longer (median: 4.61 mm (IQR: 4.50) vs 0.55 mm (IQR: 1.23), P = 0.001). Content of glands (median: 0.095 mm<sup>2</sup> (IQR: 0.30) vs 0.00 mm<sup>2</sup> (IQR: 0.01), P = 0.002) and airway smooth muscle (median: 0.25 mm<sup>2</sup> (IQR: 0.30) vs 0.060 mm<sup>2</sup> (IQR: 0.11), P = 0.02) was higher in the cryobiopsies compared with forceps biopsies. Further, the cryobiopsies had well-preserved protein antigens and mRNA. Mild to moderate bleeding was the only complication observed. Conclusion and clinical relevance: By yielding significantly larger and more intact biopsies, the cryotechnique represents a valuable new research tool to explore the bronchi in airway disease. Ultimately with the potential to create better understanding of underlying disease mechanisms and improvement of treatments.</p>}},
  author       = {{Hvidtfeldt, Morten and Pulga, Alexis and Hostrup, Morten and Sanden, Caroline and Mori, Michiko and Bornesund, Daisy and Larsen, Klaus R. and Erjefält, Jonas S. and Porsbjerg, Celeste}},
  issn         = {{0954-7894}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{27--34}},
  publisher    = {{Wiley}},
  series       = {{Clinical and Experimental Allergy}},
  title        = {{Bronchoscopic mucosal cryobiopsies as a method for studying airway disease}},
  url          = {{http://dx.doi.org/10.1111/cea.13281}},
  doi          = {{10.1111/cea.13281}},
  volume       = {{49}},
  year         = {{2019}},
}