Immunohistochemical Analysis of Mastocyte Inflammation: A Comparative Study of COPD Associated with Tobacco Smoking and Wood Smoke Exposure

<b>Background:</b> Chronic Obstructive Pulmonary Disease (COPD) exhibits some phenotypic differences between patients with biomass smoke inhalation (COPD-B) and tobacco smoking (COPD-T). COPD-B is characterized by less emphysema but more airway disease and vascular pulmonary remodeling, which are related to mast cells in lung tissues in COPD-T. Our objective was to describe the differences between the number of mast cells in COPD-B and COPD-T patients. <b>Methods</b>: A cross-sectional study was conducted on lung tissue resections for suspected cancer obtained between 2014 and 2021 from patients with documented COPD due to wood smoke or tobacco exposure. Histological samples were analyzed for mast cell count, CD34+ expression, and structural changes in lung tissue and pulmonary circulation. <b>Results</b>: A total of 20 histological samples were analyzed, with significant differences found in mast cell count [median 8 (p25-75, 5-11) vs. 2 (p75-25, 0-6), <i>p</i> = 0.016] and severe peribronchiolar fibrosis (60% vs. 10%, <i>p</i> = 0.04) between COPD-B and COPD-T patients. A positive correlation [Spearman rho = 0.879 (95% CI 0.71-0.96), <i>p</i> < 0.001] was observed between mast cell count and a gradual increase in pulmonary artery diameter. <b>Conclusions</b>: These preliminary findings suggest histological differences and the presence of mast cells between COPD-B and COPD-T, which should be confirmed in a larger number of samples and patients.