We performed a pathologic study with further using an immunohistochemical technique (using anti-p63 and anti-CK5) on tissues obtained by open lung biopsy from 18 patients with previous exposure to sulphur mustard (SM) as case group and 8 unexposed patients (control group). The most frequent pathologic diagnosis was constrictive bronchiolitis ( ), followed by respiratory ( ) and chronic cellular bronchiolitis ( ) in the case group, and hypersensitivity bronchiolitis ( ) in the control group. The pathologic diagnoses were significantly different in the case and control groups ( ). In slides stained by anti-p63 and anti-CK5, the percent of stained cells and the mean number of epithelial cells were lower in the case group in comparison to the control group. This difference was significant for the mean number of cells stained by anti-CK5 ( ). Furthermore, there was a significant correlation between pathologic diagnosis and total number of cells and mean number of cells stained with anti-p63 and anti-CK5 ( value = 0.002, <0.001, 0.044). These results suggest that constrictive bronchiolitis may be the major pathologic consequence of exposure to SM. Moreover, decrease of p63 in respiratory tissues affected by SM may suggest the lack of regenerative capacity in these patients. 1. Introduction Previous studies have reported that exposure to sulphur mustard (SM) can lead to the development of airway hyper-reactivity [1], chronic bronchitis, bronchiectasis, and lung fibrosis [2, 3], in chronic phase. However, recent studies have shown strong evidence that constrictive bronchiolitis may also be a main late complication in exposure to SM [2, 4–7]. Some studies have tried to illustrate the pathological features in persons exposed to SM. In a study using broncho-alveolar lavage (BAL), fibrosis, fibroblast proliferation, and increased collagen synthesis were observed in the patient respiratory parenchyma [4], consistent with the diagnosis of constrictive bronchiolitis [8, 9]. In another study obtaining tissue by BAL and transbronchial lung biopsy, evidence of organizing pneumonia or constrictive bronchiolitis with organizing pneumonia was observed [10]. Considering the value of pathology in the diagnosis however, immunostaining methods can confirm or further add to the data obtained from pathology, using antibodies against markers expressed in bronchial structures. Among the common used markers are cytokeratin (CK8) and surfactant (alveolar markers), CK5 and P63 (bronchial epithelial markers), CD34, CD31, and podoplanin (endothelial markers), and α-SMA (smooth muscle
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