We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Airway remodeling is correlated with obstruction in children with severe asthma.
- Authors
Tillie-Leblond, I.; de Blic, J.; Jaubert, F.; Wallaert, B.; Scheinmann, P.; Gosset, P.
- Abstract
Background: Severe asthma may involve an irreversible obstructive pattern, and structural changes in bronchial airways are believed to play a key role in this context. The aim of the present study was to compare airway remodeling in severe asthmatic children with or without obstructive pattern. Methods: Two groups of children with severe asthma and persistent symptoms, 5–14 years old were included, 15 with persistent obstructive pattern (group O) and 10 without obstructive pattern (group N). Persistent obstructive pattern was defined as a forced expiratory volume in 1 s (FEV1) less than 80% of the predicted value after a course of systemic corticosteroids and no significant improvement after bronchodilator. We examined bronchial biopsies by pathological and immunochemical methods and quantified airway smooth muscle (ASM) and mucus gland areas, reticular basement membrane (RBM) thickening, distance between ASM and RBM, muscle light chain kinase (MLCK) expression and number of vessels (CD31 expression). Results: Surface area of ASM ( P = 0.009), MLCK expression ( P = 0.03) and number of vessels ( P = 0.0008) were increased in group O compared with group N. Distance of RBM–ASM was shorter in group O ( P = 0.007). FEV1 negatively correlated with ASM area ( r = −0.6; P = 0.002), MLCK expression ( r = −0.45; P = 0.02) and CD31 expression ( r = −0.7; P = 0.0003), and positively correlated with the distance of RBM–ASM ( r = 0.5; P = 0.007). Conclusions: Structural abnormalities of airway remodeling are present in children with severe asthma. Only an increase in surface area of ASM and the density of the vascular network are more pronounced in children with persistent obstructive pattern, while RBM thickening is similar. These results are concordant with longitudinal studies which emphasize the precocity of bronchial obstruction.
- Subjects
ASTHMA in children; ASTHMATICS; RESPIRATORY allergy; OBSTRUCTIVE lung diseases; SYMPTOMS
- Publication
Allergy, 2008, Vol 63, Issue 5, p533
- ISSN
0105-4538
- Publication type
Article
- DOI
10.1111/j.1398-9995.2008.01656.x