HISTOPATHOLOGICAL ALTERATIONS IN HISTOPATHOLOGICAL ALTERATIONS IN RESPIRATORY TRACTUS OF RATS RESPIRATORY TRACTUS OF RATS

EXPOSED TO BIOMASS SMOKEEXPOSED TO BIOMASS SMOKE

Bülent Özbay*, Şükrü Acar*, Zabit Yener**, Mehmet Kanter***Bülent Özbay*, Şükrü Acar*, Zabit Yener**, Mehmet Kanter***Yuzuncu Yıl University; Yuzuncu Yıl University; * * Faculty of MedicineFaculty of Medicine , , DepartmentDepartment of Chest Diseases of Chest Diseases ****Faculty of Veterinary MedicineFaculty of Veterinary Medicine , , Department of PathologyDepartment of Pathology ******Faculty of Veterinary MedicineFaculty of Veterinary Medicine, Department of Histology, Department of Histology

VAN- TURKEYVAN- TURKEY

•Biomass fuels are frequently used Biomass fuels are frequently used

in developing countries and, in the in developing countries and, in the

Eastern Anatolia Region of Turkey Eastern Anatolia Region of Turkey

(1, 2)(1, 2)

1- Uzun K, Ozbay B. Environmental health and 1- Uzun K, Ozbay B. Environmental health and Preventive Medicine 2003; 8: 13 - 17Preventive Medicine 2003; 8: 13 - 17

2- Ozbay B, Uzun K. Functional and radiological 2- Ozbay B, Uzun K. Functional and radiological impairment in women highly exposed to indoor impairment in women highly exposed to indoor biomass fuels. Respirology 2001; 6: 255 - 8 biomass fuels. Respirology 2001; 6: 255 - 8

Common respiratory irritants

included in biomass combustion

• CO, CO2, NO2, SO2,• Ammonium, Cyanide, • Aldehyde, Ketone, Acrolein

Common Biomass Related Diseases*• Low birth weight• Growth retardation• Recurrent upper and lower respiratory

tract infections,• Chronic Bronchitis,• COPD• Reactive Bronchitis• Bronchiolitis Obliterans

*Baris YI. Solunum Hastalıkları. Atlas Kitapçılık, 1998.

• The relationships between traditional

biomass combustion and development of

COPD in women of Sivas area.

*Demirtaş N, Seyfikli Z, Topçu S. Solunum Hastalıkları 1999; 10: 156 – 8.

• Biomass fuel has deleterious effects

on pulmonary function and structure

leading to obstructive and restrictive

pathologies*

*Functional and radiological impairment in women highly exposed to indoor biomass fuels.Ozbay B, Uzun K, Arslan H, Zehir I. Respirology. 2001 Sep;6(3):255-8.

• Different aspects of indoor air pollution

such as chronic biomass smoke or wood

smoke may be relevant to the

development of obstructive lung disease*

*Weis S.T, DeMeo D.L, Postma D. S. COPD: Problems in diagnosis and measurement. Eur Respir J 2003; 21: Supll. 41, 4s – 12s.

• Biomass fuel exposure causes obstructive and restrictive spirometric impairments.

• The prevalence of the fibrotic bands, peribronchiovascular thickenings, nodular radio opacities, and curvilinear densities in the high resolution computed tomographic examinations were 7, 5, 7, and 16 times higher in the exposure group than the control group, respectively*

*Arslan M, Akkurt I, Egilmez H, Atalar M, Salk I.Biomass exposure and

the high resolution computed tomographic and spirometric findings.Eur J Radiol. 2004 Nov;52(2):192-9.

• Asthma related symptoms were

reported in 63.3 % of those who used

biomass fuel, and in 12.9 % of nonusers*

*Uzun K, Özbay B, Ceylan E, Gencer M, Zehir İ.

Prevalence of Chronic Bronchitis – Asthma symptoms in Biomass Fuel Exposed Females. Environ Health Prev Med 2003; 8: 13 – 17.

• Rural women exposed to biomass fumes

are more likely to suffer from CB and

COPD than urban women even though

the prevalence of smoking is higher

among the latter group*

*Chronic pulmonary disease in rural women exposed to biomass fumes.Kiraz K, Kart L, Demir R, Oymak S, Gulmez I, Unalacak M, Ozesmi M.Clin Invest Med. 2003 Oct;26(5):243-8.

• Domestic smoke pollution and chronic

bronchitis in a rural community of the hill

region of Nepal* *Pandey MR. Thorax 1984; 39: 337 – 9.

• Exposure to biomass smoke and chronic

airway disease in Mexican women. A case-

control study*

*Perez-Padilla R, Regalado J, Vedal S, Pare P, Chapela R, Sansores R, Selman M. Am J Respir Crit Care Med. 1996 Sep;154(3 Pt 1):701-6.

• A significant increase in lipid

peroxidation activity and a significant

decrease in antioxidant enzyme activity

in female groups who were exposed to

indoor pollution*

*Hasan G, Seyfikli Z, Kenan ÇV, Akkurt İ, Abadoğlu Ö. The effect of biomass exposure on lipid peroxidation and antioxidant enzyme activities in Turkish female groups in rural areas. Toraks 2000,1(1):13-18

Biomass Lung*

*Primitive Biomass Combustion and Lung Disease. Barış Yİ, Hoskins JA, Seyfikli Z, Demir A. Indoor and Built Environment 2002; 11: 351- 8.

• In developing countries, relevant sources of indoor pollution include biomass and coal burning for cooking and heating.

• Indoor air pollution may increase the risk of irritation phenomena, allergic sensitisation, acute and chronic respiratory disorders and lung function impairment.

• 1.5-2 million deaths per year worldwide could be attributed to indoor air pollution.

• 1 million of these deaths occur in children aged under 5 years

• Significant proportions of deaths occur due to chronic obstructive pulmonary disease and lung cancer in women.

• Further research is necessary to better evaluate the respiratory health effects of indoor pollution

Indoor air pollution and airway disease. Viegi G, Simoni M, Scognamiglio A, Baldacci S, Pistelli F, Carrozzi L, Annesi-Maesano. Int J Tuberc Lung Dis. 2004 Dec;8(12):1401-15.

• The aim of this study was to show histopathologic alterations caused by biomass smoke in rats experimentally

METHODSMETHODS

• Setting: Yuzuncu Yıl University Veterinary faculty,

• Thirty female Wistar - Albino adult rats weighing 300 g each

• Three, 6, and 9 months duration of exposure to biomass smoke

• The harvestation of rats tissues after decapitation, fixation in 10% neutral buffered formalin, and embedded in paraffin.

• Light microscopic examination

Macroscopic findingsMacroscopic findings

• Focal, small, black spots (in 6 months)

• Increased black spots (in 9 months)

• Focal abscesses, and pneumonia (9

months)

• Multiple cysts filled with mucineous fluid

(in 9 months)

Fig. 1Fig. 1. The pneumonia with abscesses. The pneumonia with abscesses

Fig. 2Fig. 2. Multiple cysts filled with mucineous . Multiple cysts filled with mucineous

fluid (in 9 months)fluid (in 9 months)

Microscopic alterationsMicroscopic alterations

. Interstitial pneumonia• Atelectasia• Emphysema• Perivascular, peribronchial and bronchiolar

cells infiltration• Papillary structures in bronchial and

bronchiolar mucosa• Sclerosis• Anthracosis

Microscopic alterationsMicroscopic alterations

• Bronchiolitis obliterans• Abscess• Necrotizing pneumonia• Tracheitis• Ulcerative tracheitis• Adenoma

Fig. 3Fig. 3. Interstitial pneumonia; atelectasia and . Interstitial pneumonia; atelectasia and

emphysemaemphysema

Fig. 4Fig. 4. The lenfoid cells infiltration in the . The lenfoid cells infiltration in the interalveolar septum.interalveolar septum.

Fig. 5Fig. 5. Alveolar emphysema. Alveolar emphysema

Fig.6Fig.6. Papillary bronchiolitis and . Papillary bronchiolitis and

peribronchiolar anthracosis.peribronchiolar anthracosis.

Fig. 7. Peribronchiolar eosinophilic cells Fig. 7. Peribronchiolar eosinophilic cells

infiltration.infiltration.

Fig. 8.Fig. 8. Sclerosis; medial thickening and Sclerosis; medial thickening and perivascular lenfoid cells infiltrations in perivascular lenfoid cells infiltrations in pulmonary vesselpulmonary vessel

Fig. 9.Fig. 9. Anthracosis in the mucosa and Anthracosis in the mucosa and

submucosa of tracheasubmucosa of trachea

Fig. 10Fig. 10. Ulcerative tracheitis and linear . Ulcerative tracheitis and linear anthracosisanthracosis

Fig. 11Fig. 11. Peribronchial fibrosis and the papillary . Peribronchial fibrosis and the papillary adenomatous proliferation of bronchial mucosa.adenomatous proliferation of bronchial mucosa.

ConclusionConclusion

• In the present study;

in the final course of our experimental trials,

we came to the conclusion that long term

exposure to biomass smoke was associated to

chronic inflammatory and premalign

alterations in the different regions of

respiratory tracts such as trachea, bronchia,

bronchioles and parenchyma.

• Long term exposure to biomass smoke

is associated with the increased number

of mast cells in the lung

*Kanter M, Yörük M, Özbay B, Karaca T, Acar Ş, Coşkun O. Distribution of mast cells in lung tissues of rats exposed to biomass smoke. Scand J Lab Anim Sci. 2004; 31: 67 - 72

• Effect of N – Acetyle Systein 0n

Histopatological and Oxidant / Antioxidant

System in the Rabbits Exposed to Biomass

Smoke*

*Levent Tetik, Fatma Fidan, Mehmet Ünlü, Çiğdem Tokyol, Mustafa Serteser, Hıdır Esme, Murat Sezer

Thorax Society 8th Annual Congress, Poster Discussion 388, 30 . 04. 2005, ANTALYA

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