Bronchoscopic mucosal cryobiopsies as a method for studying airway disease
(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.
(Less)
- author
- 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
- organization
- publishing date
- 2019-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Clinical and Experimental Allergy
- volume
- 49
- issue
- 1
- pages
- 27 - 34
- publisher
- Wiley
- external identifiers
-
- pmid:30244522
- scopus:85054798594
- 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
- 2024-06-25 00:07:02
@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 < 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}}, }