| Lung Development and Biology
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There are five stages of human lung development: the embryonic period, occurring between
3 and 6 weeks of gestation; the pseudoglandular period, from 6-16 weeks of gestation; the
canalicular period, from 16-28 weeks; the saccular period from 28-36 weeks; and the alveolar
period, from 36 weeks of gestation to about 4 years of age (10). Fetal lung development
begins with the formation of the primitive lung bud which arises from the foregut, and is
first seen as a groove in the floor of the primitive pharynx evaginates into distinct
laryngotracheal diverticulum and then elongates caudally into the primitive mesenchyme.
The lung bud is lined with endodermally derived epithelium. Formation of the major airways
occurs during the embryonic period through a dichotomous branching of the diverticulum (101).
Budding and branching of the airways continues through the pseudoglandular period and
results in the formation of the small airways including the terminal bronchioles. Budding
and branching occur in response to stimuli produced in the surrounding mesoderm. By 16 weeks
of gestation the branching of conducting portion of the tracheobronchial tree is complete,
resulting in a bilobed left lung and a trilobed right lung. At this time four of the eight
bronchiolar epithelial cell types comprising the mature lung are recognizable: ciliated,
non-ciliated (pre-Clara), secretory and early basal (37).
The respiratory structures and surrounding vasculature of the lung begin to develop
during the canalicular phase. Capillaries are positioned in close proximity to the airway
epithelium in order to allow future gas exchange. The primitive respiratory bronchioles arise
from the terminal bronchioles and contain terminal sacs that will later give rise to alveoli.
Development of the alveoli begins in the saccular phase with the subdivision of
saccules, terminal clusters of airways. These primitive alveoli are pouches in the walls
of saccules and respiratory bronchioles and are lined by type I cells. Development of true
vascularized alveoli occurs in the alveolar phase. These alveoli are lined by type I cells
and also contain alveolar type II cells necessary for the production of surfactant.
During the alveolar phase, secondary septa grow into the airspaces partitioning the more primitive
pouches into alveolar ducts and sacs. When fully developed, the structure of the alveoli is
analagous to a square room with one wall missing, where they open directly into respiratory
bronchioles or alveolar ducts and sacs.
Major Cells of theLower Respiratory Tract
(adapted from reference (10))
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