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Interstitial and Vascular Type V Collagen Morphologic Disorganization in Usual Interstitial Pneumonia

Edwin Roger Parra, Walcy R. Teodoro, Ana Paula Pereira Velosa, Cristiane Carla de Oliveira, Natalino Hajime Yoshinari and Vera Luiza Capelozzi

Department of Pathology (ERP,VLC) and Discipline of Rheumatology (WRT,APPV,CCO,NHY), University of São Paulo Medical School, São Paulo, Brazil

Correspondence to: Vera Luiza Capelozzi, MD, PhD, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Arnaldo 455, 01246-903, São Paulo, SP, Brazil. E-mail: vcapelozzi{at}lim05.fm.usp.br

Recent evidence suggests that type V collagen plays a role in organizing collagen fibrils, thus maintaining fibril size and spatial organization uniform. In this study we sought to characterize the importance of type V collagen morphological disorganization and to study the relationship between type V collagen, active remodeling of the pulmonary vascular/parenchyma (fibroblastic foci), and other collagen types in usual interstitial pneumonia (UIP). We examined type V collagen and several other collagens in 24 open lung biopsies with histological pattern of UIP from patients with idiopathic pulmonary fibrosis (IPF). We used immunofluorescence, morphometry, and three-dimensional reconstruction to evaluate the amount of collagen V and its interaction with the active remodeling progression in UIP, as well as types I and III collagen fibers. Active remodeling progression was significantly related to type V collagen density (p<0.05), showing a gradual and direct increase to minimal, moderate, and severe fibrosis degree in UIP and in the three different areas: normal, intervening, and mural-organizing fibrosis in UIP. Parenchymal changes were characterized by morphological disorganization of fibrillar collagen with diverse disarray and thickness when observed by three-dimensional reconstruction. We concluded that in the different temporal stages of UIP, vascular/parenchyma collagen type V is increased, in disarray, and is the most important predictor of survival. (J Histochem Cytochem 54:1315–1325, 2006)

Key Words: idiopathic pulmonary fibrosis • usual interstitial pneumonia • type V collagen • morphometry • three-dimensional reconstruction • survival

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