ラット胃・十二指腸液逆流モデルを用いて検討した呼吸器疾患と微量誤嚥との関連性の組織学的検討

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概要

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• Microaspiration due to gastroesophageal reflux (GER) has been suggested as a factor contributing to the development and exacerbation of several respiratory disorders. To explore the relationship between GER and respiratory disorders, we histologically examined the bilateral lungs of a rat gastroduodenal contents reflux model, which was previously used to investigate the histogenesis of Barrett’s esophagus and esophageal carcinoma. GER was surgically induced in male Wistar rats. The bilateral lungs of the reflux rats were examined with hematoxylin and eosin (HE), PAS-Alcian blue, and Azan staining at 10 and 20 weeks after surgery. Immunohistochemical staining of CD68 and α-SMA was also performed. Aspiration pneumonia with severe peribronchiolar neutrophilic and lymphocytic infiltrates, goblet cell hyperplasia, prominence of blood vessels, and increased thickness of the smooth muscle layer were detected. Bronchiolitis obliterans (BO)-like lesions comprising granulation tissue with macrophages, spindle cells, and multinucleated giant cells in the lumen of respiratory bronchioles were observed in the bilateral lungs of the reflux animals. These findings suggest that the severe inflammation and the BO-like lesions may play a role in exacerbation of the forced expiratory volume in 1 second (FEV 1) in human cases. In conclusion, we speculate that repetitive microaspiration due to GER may contribute to the exacerbation of various respiratory diseases, particularly asthma and chronic obstructive pulmonary disease (COPD), and the development of BO syndrome following lung transplantation. The reflux model is a good tool for examining the causal relationships between GER and respiratory disorders.

著者

• 向所 賢一

  滋賀医科大学 放射線科

• SUGIHARA HIROYUKI

  Department of Pathology, Kyoto Prefectural University of Medicine

• MUKAISHO KEN-ICHI

  Department of Pathology, Shiga University of Medical Science

• HATTORI TAKANORI

  Department of Pathology, Shiga University of Medical Science

• ARAKI YOSHIO

  Department of Internal Medicine, Shiga University of Medical Science

• YAMAMOTO Gaku

  Department of Chemistry, School of Science, Kitasato University

• Yamamoto Gaku

  Department Of Chemistry Faculty Of Science The University Of Tokyo

• Mukaisho Ken-ichi

  Department Of Pathology Shiga University Of Medical Science

• OUE Keisuke

  Departments of Pathology, Shiga University of Medical Science

• HIGO Tomoki

  Departments of Pathology, Shiga University of Medical Science

• NISHIKAWA Masanori

  Departments of Oral and Maxillofacial Surgery, Shiga University of Medical Science

• Sugihara Hiroyuki

  Department Of Pathology Fukui Medical School

• Araki Yoshio

  Department Of Environmental Molecular Biology Graduate School Of Environmental Earth Science Hokkaid

• Hattori Takanori

  Department Of Applied Chemistry Faculty Of Science & Technology Kinki University

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