Three-dimensional characteristics of the alveolar capillary network in infant and adult human lungs.

Background A comprehensive understanding of vascular development in the human lung is still missing.Methods Therefore, samples of infant (n = 5, 26 days to 18 months postnatally) and adult (n = 5, 20 to 40 years) human lungs were subjected to unbiased stereological estimation of the total number of capillary loops. Serial sections were segmented to visualize the alveolar capillary network (ACN) in 3D.Results The number of capillary loops increased in parallel to lung volume from 26 days to 18 months, while in adults, it was not correlated to lung volume. In infant lungs, two capillary layers were separated by a connective tissue sheet with a growing number of interconnections. In adults, the mature ACN was almost, but not completely, single-layered. Here, the connective tissue was thinner but still centrally positioned, suggesting the persistence of interconnected parts of both layers of the previously double-layered ACN.Conclusions Small parts of the capillaries remain double-layered and seem to be grouped around the thin connective tissue sheet, suggesting a different mechanism of microvascular maturation than simple fusion of the two layers. These spots are a potential basis for further alveolarization after completion of bulk formation.Impact The 3D data offer a new conceptual approach to microvascular maturation of the lung. Microvascular maturation rather results from reduction than simple fusion of capillary fragments. Adult lungs maintain small double-layered capillary spots. These could offer a potential source of regeneration. The data are important to better understand normal and pathological lung development.