Anatomical variability in the upper tracheobronchial tree: sex-based differences and implications for personalized inhalation therapies.
J Appl Physiol (1985)
; 130(3): 678-707, 2021 03 01.
Article
em En
| MEDLINE
| ID: mdl-33180641
ABSTRACT
The morphometry of the large conducting airways is presumed to have a strong effect on the regional deposition of inhaled aerosol particles. Nevertheless, sex-based differences have not been fully quantified and are still largely ignored in designing inhalation therapies. To this end, we retrospectively analyzed high-resolution computed tomography scans for 185 individuals (90 women, 95 men) in the age range of 12-89 yr to determine airway luminal areas, airway lengths, and bifurcation angles. Only subjects free of chronic airway disease were considered. In men, luminal areas of the upper conducting airways were, on average, â¼30%-50% larger when compared with those in women, with the largest differences found in the trachea (289.72 ± 54.25 vs. 193.50 ± 42.37 mm2 for men and women, respectively). The ratio of the largest luminal area in men to the smallest luminal area in women (in any given segment) ranged between 4.5 and 8.6, the largest differences being found in the lobar bronchi. Sex-based differences were minor in the case of bifurcation angles (e.g., average main bifurcation angle 93.04 ± 9.58° vs. 91.03 ± 9.81° for men and women, respectively), but large intersubject variability was found irrespective of sex (e.g., range of main bifurcation angle 65.04°-122.01° vs. 69.46°-113.94° for men and women, respectively). Bronchial segments were shorter by â¼5%-20% in women relative to men, the largest differences being located in the upper lobes. False discovery rate analysis revealed statistically significant associations among morphometric measures of the right lung in women (but not in men), suggesting two phenotypes among women that we attribute to the smaller female thoracic volume.NEW & NOTEWORTHY We found significant sex-based morphometric differences in the central airways of healthy men and women that were only mildly attenuated in subsets matched for lung volume. Lumen areas were significantly larger in men (â¼30%-50%). Large variability (â¼75%-87%) in airway bifurcation angles (60°-122°) was found irrespective of sex. The branching pattern of the right main and right upper bronchi in women (but not in men) follows two phenotypes modulated by lung volume.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Traqueia
/
Brônquios
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Appl Physiol (1985)
Assunto da revista:
FISIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Chipre