Introduction

Ageing is associated with lung function decline and small airway (SA) loss. The mechanisms of SA loss in ageing are poorly understood. Our aim was to investigate abnormalities of SA pathology during ageing.

Methods

Using lung tissue sections obtained from peripheral lung tissue, we measured SA remodelling (epithelial expansion, airway wall thickness, luminal narrowing and alveolar attachment loss) and alveolar space size. We enumerated neutrophils in the SA and alveolar septum by immunohistochemistry.

Results

Alveolar attachment numbers decreased with age (rho=-0.5 p=0.02). Alveolar space size increased with age (rho=0.5 p=0.006). There were no associations between epithelial expansion, airway wall thickness, luminal narrowing and age. SA diameter was negatively correlated with luminal narrowing (rho=-0.7 p<0.001). The numbers of alveolar septum neutrophils were significantly correlated with age (rho=0.5 p=0.04). 

Conclusion

Healthy ageing is associated with a reduction in alveolar attachment numbers, which appears to be caused by age related neutrophilic inflammation. This may contribute to airway closure and precede airway loss during ageing.