PT  - JOURNAL ARTICLE
AU  - H. Fehrenbach
TI  - Animal models of pulmonary emphysema: a stereologist's perspective
AID  - 10.1183/09059180.00010104
DP  - 2006 Dec 01
TA  - European Respiratory Review
PG  - 136--147
VI  - 15
IP  - 101
4099  - http://err.ersjournals.com/content/15/101/136.short
4100  - http://err.ersjournals.com/content/15/101/136.full
SO  - EUROPEAN RESPIRATORY REVIEW2006 Dec 01; 15
AB  - A variety of animal models have been suggested as models of pulmonary emphysema; these are critically discussed in the present article from a stereologist's perspective. In addition, a stereological design for the quantification of experimentally induced emphysema is proposed. On the basis of the widely accepted definition of pulmonary emphysema being an “abnormal permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls,” quantitative morphology is the only method with which to reliably assess the presence of emphysema. Recognising this, careful inspection of animal models that are based on instillation of elastase, genetic alterations, inhalation of cigarette smoke or induction of apoptosis, reveals that both criteria of emphysema definition were demonstrated in surprisingly few of them. Several aspects are suggested to be critical for the understanding of animal models of human emphysema. For example, genetic models that rely on the inhibition of the formation of alveoli during post-natal alveolarisation should clearly be distinguished from models that rely on the loss of mature alveoli after alveolarisation is complete. Furthermore, inhalation models that are characterised by exposed animals exhibiting a severe loss of body weight should carefully examine the relative contribution of intervention and weight loss, respectively. Models that rely on the exposure of juvenile animals for several weeks or even months should take into account the effects of normal lung growth and ageing. Stereology offers appropriate tools with which to quantify the parameters relevant to assess development and the regeneration of emphysema. Stereologists continue to develop tools that will help ascertain the reliability of established and new models. If inappropriate parameters continue to be used for the evaluation of animal models of emphysema, thinking and resources are likely to be misdirected and the models may limit rather than expand the understanding of human emphysema and the development of new therapies.