Morphologic and morphometric characterization of lung collagen content in clinically normal adult Thoroughbreds in race training
Authors: Lakritz Jeffrey , Wisner Erik R. , Finucane Thomas , O'Brien Timothy R. , Tyler Walter S. , Pascoe John R. , Plopper Charles G. 
Published: January 2024

SUMMARY
Interstitial and bronchointerstitial pulmonary patterns are commonly observed in thoracic radiographs of Thoroughbreds. Prominent interstitial and bronchointerstitial pulmonary patterns are observed in clinically normal horses, and in horses with respiratory tract disease. Until recently, the relevance of these pulmonary patterns was not known. Previous studies indicated that bronchiolitis, bronchiolar epithelial hyperplasia, epithelial metaplasia, and bronchial arteriolar recruitment correlated strongly with the prominence of the interstitial and bronchointerstitial pulmonary patterns observed radiographically. We examined the content and distribution of collagen in the lungs of 7 clinically normal Thoroughbreds in race training. After standardized fixation, lung tissue was treated with a compound that selectively stains collagen. Standard morphometric techniques were used to determine the volume density of parenchymal tissue and parenchymal airspace, mean linear intercept (estimate of alveolar size), alveolar surface area-to-volume ratio, percentage of parenchyma composed of collagen, percentage of airway wall composed of collagen, and airway wall thickness. These values were compared with radiographic and histopathologic scores obtained from the same horses. The volume density of parenchymal tissue and small airway wall thickness correlated strongly with the prominence of the bronchial and bronchointerstitial pulmonary patterns observed radiographically. Small airway thickness was also highly correlated with the perceived prominence of the interstitial pulmonary patterns observed radiographically, and morphometric estimates of parenchymal tissue and parenchymal collagen. There were also strong correlations between the volume density of parenchymal tissue, the percentage of parenchymal collagen, peribronchiolar mononuclear cell infiltrates, and bronchiolar mucosal plication estimates. In horses with more prominent bronchiolar mucosal plication, there was a strong direct relation to the observed prominence of peribronchiolar and submucosal blood vessels, and the bronchial and bronchointerstitial patterns observed radiographically. Horses with prominent peribronchiolar mononuclear cell infiltrates also had more obvious interstitial and bronchointerstitial pulmonary patterns observed radiographically. There also was a direct correlation between the percentage of parenchymal collagen and the observed prominence of peribronchiolar and submucosal blood vessels in these horses. In all horses, there was a strong negative correlation between the estimated average alveolar size and the observed severity of the vascular and bronchial patterns observed radiographically.
Four horses with the greatest estimated airway wall and interalveolar collagen had more prominent interstitial and bronchointerstitial densities and histopathologic evidence of bronchiolitis. These horses had evidence of epithelial basement membrane disruption, with disorganized collagen fibers running between the adventitial layer and the epithelial basement membrane. Amounts of collagen were greater in the adventitia and interalveolar septa, with the fibers appearing larger and more coarse and disorganized. In horses with the greatest percentage of interalveolar septal collagen, accumulations of collagen were larger in the interalveolar septal tips. These findings suggest that horses with prominent interstitial and bronchointerstitial pulmonary patterns radiographically have undergone previous episodes of pulmonary injury, which has resulted in deposition of increased amounts of collagen in interalveolar septa and airway walls.