HISTOPATHOLOGICAL ALTERATIONS IN RESPIRATORY TRACTUS OF RATS EXPOSED TO BIOMASS SMOKE

1. HISTOPATHOLOGICAL ALTERATIONS IN RESPIRATORY TRACTUS OF RATS EXPOSED TO BIOMASS SMOKE Bülent Özbay*, Şükrü Acar*, Zabit Yener**, Mehmet Kanter*** Yuzuncu Yıl University; * Faculty of Medicine , Department of Chest Diseases **Faculty of Veterinary Medicine , Department of Pathology ***Faculty of Veterinary Medicine, Department of Histology VAN- TURKEY

2. Biomass fuels are frequently used in developing countries and, in the Eastern Anatolia Region of Turkey (1, 2) 1- Uzun K, Ozbay B. Environmental health and Preventive Medicine 2003; 8: 13 - 17 2- Ozbay B, Uzun K. Functional and radiological impairment in women highly exposed to indoor biomass fuels. Respirology 2001; 6: 255 - 8

3. Common respiratory irritants included in biomass combustion • CO, CO2, NO2, SO2, • Ammonium, Cyanide, • Aldehyde, Ketone, Acrolein

4. Common Biomass Related Diseases* • Low birth weight • Growth retardation • Recurrent upper and lower respiratory tract infections, • Chronic Bronchitis, • COPD • Reactive Bronchitis • Bronchiolitis Obliterans *Baris YI. Solunum Hastalıkları. Atlas Kitapçılık, 1998.

5. The relationships between traditional biomass combustion and development of COPD in women of Sivas area. *Demirtaş N, Seyfikli Z, Topçu S. Solunum Hastalıkları 1999; 10: 156 – 8.

6. Biomass fuel has deleterious effects on pulmonary function and structure leading to obstructive and restrictive pathologies* *Functional and radiological impairment in women highly exposed to indoor biomass fuels.Ozbay B, Uzun K, Arslan H, Zehir I.Respirology. 2001 Sep;6(3):255-8.

7. Different aspects of indoor air pollution such as chronic biomass smoke or wood smoke may be relevant to the development of obstructive lung disease* *Weis S.T, DeMeo D.L, Postma D. S. COPD: Problems in diagnosis and measurement. Eur Respir J 2003; 21: Supll. 41, 4s – 12s.

8. Biomass fuel exposure causes obstructive and restrictive spirometric impairments. • The prevalence of the fibrotic bands, peribronchiovascular thickenings, nodular radio opacities, and curvilinear densities in the high resolution computed tomographic examinations were 7, 5, 7, and 16 times higher in the exposure group than the control group, respectively* *Arslan M, Akkurt I, Egilmez H, Atalar M, Salk I.Biomass exposure and the high resolution computed tomographic and spirometric findings.Eur J Radiol. 2004 Nov;52(2):192-9.

9. Asthma related symptoms were reported in 63.3 % of those who used biomass fuel, and in 12.9 % of nonusers* *Uzun K, Özbay B, Ceylan E, Gencer M, Zehir İ. Prevalence of Chronic Bronchitis – Asthma symptoms in Biomass Fuel Exposed Females. Environ Health Prev Med 2003; 8: 13 – 17.

10. Rural women exposed to biomass fumes are more likely to suffer from CB and COPD than urban women even though the prevalence of smoking is higher among the latter group* *Chronic pulmonary disease in rural women exposed to biomass fumes.Kiraz K, Kart L, Demir R, Oymak S, Gulmez I, Unalacak M, Ozesmi M.Clin Invest Med. 2003 Oct;26(5):243-8.

11. Domestic smoke pollution and chronic bronchitis in a rural community of the hill region of Nepal* *Pandey MR. Thorax 1984; 39: 337 – 9. • Exposure to biomass smoke and chronic airway disease in Mexican women. A case-control study* *Perez-Padilla R, Regalado J, Vedal S, Pare P, Chapela R, Sansores R, Selman M. Am J Respir Crit Care Med. 1996 Sep;154(3 Pt 1):701-6.

12. A significant increase in lipid peroxidation activity and a significant decrease in antioxidant enzyme activity in female groups who were exposed to indoor pollution* *Hasan G, Seyfikli Z, Kenan ÇV, Akkurt İ, Abadoğlu Ö. The effect of biomass exposure on lipid peroxidation and antioxidant enzyme activities in Turkish female groups in rural areas. Toraks 2000,1(1):13-18

13. Biomass Lung* *Primitive Biomass Combustion and Lung Disease. Barış Yİ, Hoskins JA, Seyfikli Z, Demir A. Indoor and Built Environment 2002; 11: 351- 8.

14. In developing countries, relevant sources of indoor pollution include biomass and coal burning for cooking and heating. • Indoor air pollution may increase the risk of irritation phenomena, allergic sensitisation, acute and chronic respiratory disorders and lung function impairment. • 1.5-2 million deaths per year worldwide could be attributed to indoor air pollution. • 1 million of these deaths occur in children aged under 5 years • Significant proportions of deaths occur due to chronic obstructive pulmonary disease and lung cancer in women. • Further research is necessary to better evaluate the respiratory health effects of indoor pollution Indoor air pollution and airway disease. Viegi G, Simoni M, Scognamiglio A, Baldacci S, Pistelli F, Carrozzi L, Annesi-Maesano. Int J Tuberc Lung Dis. 2004 Dec;8(12):1401-15.

15. The aim of this study was to show histopathologic alterations caused by biomass smoke in rats experimentally

16. METHODS • Setting: Yuzuncu Yıl University Veterinary faculty, • Thirty female Wistar - Albino adult rats weighing 300 g each • Three, 6, and 9 months duration of exposure to biomass smoke • The harvestation of rats tissues after decapitation, fixation in 10% neutral buffered formalin, and embedded in paraffin. • Light microscopic examination

17. Macroscopic findings • Focal, small, black spots (in 6 months) • Increased black spots (in 9 months) • Focal abscesses, and pneumonia (9 months) • Multiple cysts filled with mucineous fluid (in 9 months)

18. Fig. 1. The pneumonia with abscesses

19. Fig. 2. Multiple cysts filled with mucineous fluid (in 9 months)

20. Microscopic alterations .Interstitial pneumonia • Atelectasia • Emphysema • Perivascular, peribronchial and bronchiolar cells infiltration • Papillary structures in bronchial and bronchiolar mucosa • Sclerosis • Anthracosis

21. Microscopic alterations • Bronchiolitis obliterans • Abscess • Necrotizing pneumonia • Tracheitis • Ulcerative tracheitis • Adenoma

22. Fig. 3. Interstitial pneumonia; atelectasia and emphysema

23. Fig. 4. The lenfoid cells infiltration in the interalveolar septum.

24. Fig. 5. Alveolar emphysema

25. Fig.6. Papillary bronchiolitis and peribronchiolar anthracosis.

26. Fig. 7. Peribronchiolar eosinophilic cells infiltration.

27. Fig. 8. Sclerosis; medial thickening and perivascular lenfoid cells infiltrations in pulmonary vessel

28. Fig. 9. Anthracosis in the mucosa and submucosa of trachea

29. Fig. 10. Ulcerative tracheitis and linear anthracosis

30. Fig. 11. Peribronchial fibrosis and the papillary adenomatous proliferation of bronchial mucosa.

31. Conclusion • In the present study; in the final course of our experimental trials, we came to the conclusion that long term exposure to biomass smoke was associated to chronic inflammatory and premalign alterations in the different regions of respiratory tracts such as trachea, bronchia, bronchioles and parenchyma.

32. Long term exposure to biomass smoke is associated with the increased number of mast cells in the lung *Kanter M, Yörük M, Özbay B, Karaca T, Acar Ş, Coşkun O. Distribution of mast cells in lung tissues of rats exposed to biomass smoke. Scand J Lab Anim Sci. 2004; 31: 67 - 72

33. Effect of N – Acetyle Systein 0n Histopatological and Oxidant / Antioxidant System in the Rabbits Exposed to Biomass Smoke* *Levent Tetik, Fatma Fidan, Mehmet Ünlü, Çiğdem Tokyol, Mustafa Serteser, Hıdır Esme, Murat Sezer Thorax Society 8th Annual Congress, Poster Discussion 388, 30 . 04. 2005, ANTALYA

38. Teşekkürler