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Center for Comparative Respiratory Biology and Medicine, California National Primate Research Center, University of California, Davis, California
Submitted 20 January 2006 ; accepted in final form 19 April 2006
| ABSTRACT |
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oxidant air pollution; adverse effects; growth and development; lung
Children may be more at risk to the adverse effects of air pollution than adults are for several reasons. First, children have a higher minute ventilation and a higher level of activity compared with adults (reviewed in Ref. 26). Second, children spend more time outdoors than adults do, increasing exposure to air pollutants (reviewed in Ref. 1). Third, lung development is a long-term process. Although the human lung needs to be sufficiently formed at birth to perform its primary function, gas exchange, lung growth continues for an extensive period (812 years) after birth (6). During this time, there are multifold increases in overall lung size, active cellular differentiation, cell division, and alveolar formation. As a result, airways change in size and shape with maturation, altering deposition patterns. In addition, lung function continues to change, increasing until late adolescence in both males and females, when it plateaus (3, 17, 39).
Although it is well recognized and accepted that air pollution affects lung function and growth in children (7, 15, 17, 23, 29, 32, 33, 43), results from epidemiological studies differ in the contribution that the oxidant pollutant ozone plays in these alterations. Epidemiologic studies differ in design, methods of assigning exposure, methods of assessing lung function, and populations studied. To study directly the effect that ozone has on lung growth, controlled experimental studies are needed.
Chronic airway disease and decreased lung function in children exposed to ambient air pollution may be due to repeating cycles of injury and repair, which alter normal lung maturation. To address how repeated exposures to episodes of ozone affects airway development, we exposed infant rhesus monkeys to cyclic episodes of 0.5 parts per million ozone for 5 mo. This concentration of ozone is equivalent to high environmental concentrations found in Mexico City. Nonhuman primates were chosen as a model because their airway structure and postnatal lung development is similar to those of humans. The distal portion of the airway tree in nonhuman primates is similar to that described in humans (20, 50), consisting of a terminal bronchiole (the most distal nonalveolarized conducting airway) followed by several generations of respiratory bronchioles (small airways with alveolar outpocketings in the walls) (36) opening into the alveolar region (46). After evaluating airway architecture, epithelial composition, and airway wall smooth muscle bundle orientation, we conclude that exposure to environmental ozone during the early postnatal period alters the development of the distal pulmonary airways. Some of the results from these studies have been previously reported in abstract form (14).
| METHODS |
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Gross dissection and tissue fixation. All animals were killed after the 11th cycle at 6 mo of age. The monkeys were weighed and then sedated with Telazol (8 mg/kg im) and anesthetized with Diprivan (0.10.2 mg/kg/min iv), with the dose adjusted as necessary by the attending veterinarian. The monkeys were euthanized with an overdose of pentobarbital sodium followed by exsanguination through the abdominal aorta. Three lung lobes (described below) were immediately inflation fixed via bronchial cannula for 4 h at 30-cm fluid pressure. The left cranial lobe was fixed with 1% paraformaldehyde in 0.1 M phosphate buffer (pH 7.2). The right middle lobe was fixed with 1% glutaraldehyde-1% paraformaldehyde in cacodylate buffer (adjusted to pH 7.4, 330 mosM), and lung lobe volume was measured by fluid displacement after fixation. The right cranial lobe was fixed with 4% paraformaldehyde. After fixation, the left cranial lobe was separated into the cranial and caudal segments.
Evaluation of distal airways. The caudal segment of the left cranial lobe was microdissected by placing one blade of a pair of microdissecting spring scissors into the airway lumen and cutting along the axial path of the airway tree. This exposes the luminal surface of the airway and leaves the parenchyma attached to the airway wall as described in detail previously (35). Airway branches were numbered and recorded in a three-dimensional manner (Fig. 1, A and B). To determine whether postnatal ozone exposure alters alveolarization of the distal conducting airway, the number of airway generations in the main axial pathway from the lobar bronchus to the junction with the first alveolar outpocketing was counted in each of the four lobes.
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To ensure that the histological evaluation of the airways compared exactly the same intrapulmonary airway generations in each monkey, the branching patterns of the axial path in the cranial segment of the left cranial lobe and the right cranial lobe were recorded as described above. Because the airway lumen was exposed by one cut and the rest of the lung remained intact and attached, the lobe could then be cut into 1-cm-thick slices perpendicular to the long axis of the main airway, washed in 0.2 M phosphate buffer for 30 min, and embedded in paraffin. Paraffin sections (56 µm thick) were deparaffinized, and mucous cells were identified by positive staining as stained with Alcian blue-periodic acid-Schiff.
Airway-specific epithelial composition was evaluated by high-resolution light microscopy (35). Again, the airway branching pattern of the axial path in the right middle lobe was recorded, and the lobe was sliced 1 mm thick for high-resolution light microscopy. The pieces were embedded in Araldite 502, following a process that allows selection of specific areas from large tissue faces (35). Areas containing airways of interest were isolated from the large blocks and remounted. Sections 0.5 µm thick were cut with glass knives and stained with a solution of 1% toluidine blue. The surface epithelia of microdissected airways of the left cranial lobe, caudal segment (costal half), were also evaluated by scanning electron microscopy as described previously (44). Airways were imaged with a Philips SEM 501 microscope (FEI, Hillsboro, OR).
Distal airway smooth muscle bundles were evaluated as described previously (40, 45). Smooth muscle bundle orientation, bundle abundance, and profile length and diameter were measured. The microdissected airways of the left cranial lobe, caudal segment (mediastinal half), were permeabilized with 0.3% Triton X-100, washed with PBS, incubated in 0.066 µM Alexa Fluor 568 phalloidin (a probe for polymerized actin; Molecular Probes, Eugene, OR) for 20 min, and then washed again with PBS. Distal airway generations were imaged with laser scanning confocal microscopy [Bio-Rad MRC 1024 ES (Hercules, CA) mounted on an Olympus BX50WI microscope (Melville, NY)] as described previously (40). 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. Briefly, a x10 long-working-distance water-immersion objective was used, and a series of images was taken through each terminal and respiratory bronchiole at focal planes that were 2040 µm apart with a focus depth of 20 µm. With the use of LaserSharp 2000 software (Bio-Rad Cell Sciences Division, Hemp Hempstead, UK), 510 images were stacked together to produce three-dimensional composites of specific areas of the airway tree ![]()
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(Fig. 5). The final magnification was x170. Smooth muscle bundle orientation was measured as the angle of deviation (
) from perpendicular to the long axis of the airway segment. The long axis of each airway was defined as the plane parallel to the walls of the airway. 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 SD were also calculated. Bundle abundance and profile size were determined by defining the boundaries of each airway segment on composite images. Three linear probes were oriented parallel to the long axis of the airway and 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.
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| RESULTS |
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Airway architecture. Respiratory bronchioles are differentiated from terminal bronchioles by the presence of alveolar outpocketings. In filtered-air control infant monkeys, the most proximal alveolar outpocketings occurred after an average of 13 or 14 generations of branching airways down the axial path beginning at the trachea. However, in ozone-exposed infant monkeys, the most proximal alveolar outpocketings occurred after an average of only 10 generations of airway branching starting at the trachea (Fig. 2). Infant monkeys exposed to ozone had significantly fewer generations of purely conducting airway generations (with no alveolar outpocketings) in three of the four lobes evaluated. Ozone-exposed monkeys had an average loss of three conducting airway generations per axial path for each lobe (Fig. 2).
The length and diameter of the last strictly conducting (terminal) bronchiole and the first respiratory bronchiole, at the boundary of the conducting airways and the gas-exchange area, were measured. This area was chosen because it is the most precisely defined area between the strictly conducting airways (terminal bronchiole) and the conducting airways and gas-exchange area (respiratory bronchiole). Terminal bronchioles of ozone-exposed monkeys were an average of 38% narrower and 45% shorter than terminal bronchioles of filtered-air control monkeys. In contrast, although the most proximal respiratory bronchioles of ozone-exposed monkeys were 41% narrower than the bronchioles of filtered-air control monkeys, the length of this airway did not differ significantly (Table 1). Therefore, after ozone exposure, both the terminal bronchiole and most proximal respiratory bronchiole were smaller than their filtered-air counterparts.
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Airway smooth muscle. In the terminal bronchiolar airways (generations 12 and 13) of filtered-air control monkeys, the majority of the smooth muscle bundles (73.3%) around the airway were oriented at an angle <15° from perpendicular to the long axis of the airway and only a very small percentage (2.6%) of bundles were found at an angle >30° (Fig. 5C). In ozone-exposed monkeys, only 43.0% of the terminal bronchiolar (generations 811) smooth muscle bundles were oriented at an angle <15° from perpendicular to the long axis of the airway, but 12.2% of bundles were oriented at an angle of >30° (Fig. 5D). There was no significant difference in terminal bronchiolar smooth muscle bundle thickness (27.6 [SD 6.5], 33.2 µm [SD 13.9]) or abundance (1.51 [SD 0.3], 1.49 [SD 0.4] bundles per 100 µm) between filtered-air and ozone-exposed monkeys, respectively. An opposite pattern of smooth muscle bundle orientation was present in the most proximal respiratory bronchiole. Only half (51.6%) of the smooth muscle bundles in the proximal respiratory bronchioles (generations 12 and 13) of filtered-air control monkeys were oriented around the airway at an angle <15° from perpendicular to the long axis of the airway, and 16.4% of bundles were oriented at an angle of >30° (Fig. 5E). In the first respiratory bronchiole (generations 811) of ozone-exposed monkeys, 64.1% of the smooth muscle bundles were oriented at an angle <15° from perpendicular to the long axis of the airway, with only 5.5% of the bundles oriented at an angle of >30° (Fig. 5F). As in the terminal bronchioles, however, there were no significant differences in smooth muscle bundle thickness (27.5 [SD 4.6], 22.8 µm [SD 3.5]) or abundance (1.35 [SD 0.3], 1.77 [SD 0.1] bundles per 100 µm) in the first respiratory bronchioles between filtered-air control monkey and ozone-exposed monkeys, respectively.
| DISCUSSION |
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The monkeys described in the present study are the same type of monkeys evaluated for pulmonary function by Schelegle et al. (38). In these monkeys, exposure to ozone during postnatal lung development resulted in a marked increase in baseline airway resistance (a twofold increase). Elevated airway resistance in respiratory diseases such as asthma is often associated with remodeling of the airways that conduct air to the gas-exchange area of the lung. To identify the structural alterations that may contribute to the increased airway resistance in ozone-exposed infant monkeys, we analyzed the transition to alveolarized airways in the main axial path distal conducting airways, the composition of the airway cells, and the structure of the smooth muscle surrounding those airways.
Exposure of infant monkeys to cyclic episodes of ozone produced three major alterations: loss of the number of strictly conducting airways, reduction of distal airway size, and alterations in smooth muscle bundle orientation. The number of strictly conducting airways (those without alveoli) along the main axial pathway of four lung lobes was three generations shorter in monkeys exposed to ozone than in monkeys exposed only to filtered air. Our present study corroborates previous experimental studies of growing lungs of juvenile nonhuman primates. Both daily and seasonal (every other month) ozone exposures over 18 mo in young monkeys (7 mo of age at start of exposure) resulted in significant increases in the volume proportion of the respiratory bronchioles vs. that shown in age-matched filtered-air controls (47). This increase in the volume proportion of respiratory bronchioles was also present in young monkeys (6 mo of age at start of exposure) exposed to daily ozone for only 12 mo and persisted after an additional 6-mo recovery period (48). These changes were not associated with changes in the volume proportion of parenchymal or alveolar compartments of the lung (47, 48), suggesting that the increase in respiratory bronchioles may come from alveolarization of conducting airways.
In ozone-exposed infant monkeys, axial path terminal bronchioles were 50% shorter than axial path terminal bronchioles of filtered-air control animals. In addition, the first respiratory bronchiole of the main axial path from ozone-exposed infants was 60% narrower than that shown in filtered-air control animals. A change in the geometry of the distal airways may have important implications in altering the distribution of air flow. Computational studies suggest that, as diameter decreases, the average air flow velocity falls (34), indicating that the velocity of air flow in the smaller diameter distal airways of ozone-exposed infant monkeys would be less than the airflow in the larger-diameter distal airways of filtered-air control infant monkeys. Airway resistance may also be altered by changes in the geometry of the distal airways. Airway resistance in the giant pouched rat (a large rodent) is disproportionately larger than the airway resistance in the harvest mouse (a small rodent) (19). The difference in airway resistance is amplified by the effects of the rat's disproportionately smaller airways. These data suggest that the decrease in diameter of the distal airways of ozone-exposed infant monkeys may play a large role in the increased airway resistance reported previously (38).
Because changes in airway smooth muscle have been implicated in excessive bronchoconstriction and affect resistance, we evaluated the structure of the smooth muscle surrounding the terminal bronchioles and first respiratory bronchioles in the infant monkeys. The bronchioles are important contributors to airway resistance during the first 5 years of life in humans (22). There is also physiological and pathological evidence that bronchioles play a role in asthma [see Kraft (27) for review]. Three-dimensional analysis of complete airway segments with dyes that identify actin suggested significant changes in one aspect of the smooth muscle bundles surrounding the terminal and the most proximal respiratory bronchioles: orientation of individual bundles. Theoretical studies suggest that smooth muscle orientation (helical pitch) is an important factor in airway contractility (5). Ozone exposure during postnatal development in infant monkeys increases the percentage of smooth muscle bundles in terminal bronchioles oriented at angles >30° and decreases the percentage of angles <15° from the perpendicular to the long axis of the airway. However, in the next most-distal generation, the proximal respiratory bronchiole, postnatal ozone exposure resulted in a decrease in the percentage of smooth muscle bundles oriented at angles >30° and an increase in the percentage <15° from the perpendicular to the long axis of the airway. These changes would enhance the ability of the smooth muscle components in distal airways to produce increases in airway resistance for either less nervous stimulation for contraction or less force of contraction for each response (5). In humans, smooth muscle appears to be one of the earliest components to be changed in remodeled airways in patients suffering from fatal asthma.
The molecular mechanism behind the abnormal development of distal conducting airways in animals exposed to ozone may be related to the depletion of perlecan in the basement membrane zone (11). Perlecan is a proteoglycan responsible for many functions, in particular, regulation of growth factor trafficking between cells of the epithelial-mesenchymal unit (13, 24). Ozone-induced depletion of perlecan from the basement membrane zone in trachea was associated with altered regulation of FGF-2 signaling (11, 12). Depletion of perlecan would also affect regulation of the other growth factors that bind to perlecan, including FGF-1, FGF-7, PDGF, hepatocyte growth factor, heparin binding EGF, VEGF, and TGF-
(25). The functional consequences of deregulation of these collective molecules are significant because they are the basis for much of the cell-cell interactions in the epithelial mesenchymal trophic unit responsible for development of the airway.
The present study identifies the early postnatal period of lung development as highly susceptible to alterations by oxidant air pollutants. The remodeling in the distal conducting airways of young rhesus monkeys exposed since infancy to cyclic episodes of ozone reported in this study provides a pathophysiological basis for the decrement in small airway function reported in college freshmen who have grown up in polluted areas of California's South Coast Air Basin (29, 43).
| 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.
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