Is centrilobular emphysema the link to the Dutch hypothesis?
Bibliographic record
Abstract
Asthma and COPD are chronic obstructive diseases with a certain degree of physiologic and pathologic similarities and the Dutch Hypothesis proposes that these diseases could be phenotypes of the same process. This hypothesis has never been universally accepted due to the evident differences between the two diseases. However COPD has two distinct pathological phenotypes, Panlobular Emphysema (PLE) where airflow obstruction is secondary to loss of elasticity and Centrilobular Emphysema (CLE) where airflow obstruction is secondary to bronchiolar remodeling with increased muscle and smaller diameter. We hypothesize that CLE could have features of Asthma different from PLE, especially as far as mast cells (MC) inflammation and their relation to airway reactivity. Therefore, we quantified tryptase stained MC in all layers (submucosa, smooth muscle and adventitia) of small airways in 27 lungs with CLE, 24 with PLE, 8 smokers without emphysema (SNE) and 8 non smokers (NS). MC in smooth muscle of small airways were significantly higher in CLE (206±41 cells/mm 2 ) than in PLE (104±21 cells/mm 2 ; p=0.01), SNE (107±54 cells/mm 2 ; p=0.05) and NS (105±27 cells/mm 2 ; p=0.05). Moreover, the degree of MC infiltration in the smooth muscle was related with the degree of hyperresponsiveness, as it has been shown in Asthma (PC20<3mg/ml: 396±116 cells/mm 2 , PC20 3-8mg/ml: 89±69 cells/mm 2 and PC20>8mg/ml: 107±21 cells/mm 2 ; p=0.02 for all). In conclusion, MC infiltration of the muscle layer and its relation to airway reactivity, an important mechanism in the pathogenesis of Asthma, is a prominent feature of COPD patients with CLE, but not with PLE. These findings suggest that CLE could be the COPD link to the Dutch Hypothesis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.004 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".