Follow-up question: growth and lung function

Question

Dear Dr. Posselt,

Many thanks for your answer, to which I have a further question.

This is indeed about structural changes; you write that “lung tissue has a very low regenerative ability.”

This could be positive during growth, though: the scar tissue does not grow, but the lungs as a whole do. In that sense, the percentage of healthy areas would have to grow.

Could one hope that the amount of healthy tissue that grows back is disproportionally high?

Many thanks,

Answer

Dear questioner,

in cases of structural changes in the lungs that come with a destruction or long-term lack of airing of the pulmonary alveoli, it has to be assumed that the loss of alveoli will not be restored through an increased regeneration of healthy tissue during growth. The remaining lung tissue has more space in the thorax, which leads to a compensatory inflation of the remaining alveoli. In case of minor structural changes, this cannot be noticed with image guided procedures. Should a larger lung segment fail e.g. due to a long-term lack of airing (atelectasis), this can be seen. Minor structural changes do not necessarily result in reduced fitness, since the lungs do have a certain (though limited) reserve capacity. Above all, it is important to know that any lung damage that has already happened usually means a weak spot from which further problems could occur in the future. Such damage includes e.g. destroyed ciliated epithelium or light tubular bronchiectasis, which lead to a worse elimination of mucus particles. In general, it has to be maintained that so-called stem cells in the lungs do exist, which in theory bear the potential of re-growing. However, these are not activated in case of damage caused through inflammation. Therefore, getting the best possible therapy for your child in order to prevent further lung damage should be of highest priority.

Kind regards
Dr. H.-G. Posselt

01.02.2010