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Noneosinophilic asthma in children: relation with airway remodelling.
- Source :
-
The European respiratory journal [Eur Respir J] 2011 Sep; Vol. 38 (3), pp. 575-83. Date of Electronic Publication: 2011 Feb 10. - Publication Year :
- 2011
-
Abstract
- Noneosinophilic asthma is increasingly recognised as an important clinical-pathological phenotype in adults. However, this entity has scarcely been investigated in children. In particular, it is unknown whether airway remodelling would develop in children with non-eosinophilic asthma to the same degree as in children with eosinophilic disease. We analysed bronchial biopsies from 80 children undergoing bronchoscopy for appropriate clinical indications: 21 with noneosinophilic asthma, 34 with eosinophilic asthma and 25 control children. Features of airway remodelling - basement membrane thickening, epithelial loss and angiogenesis - and immune activation - inflammatory infiltrate, interleukin (IL)-4, IL-5, transforming growth factor (TGF)-β, TGF-β receptor type II - were quantified by histology and immunohistochemistry. The main components of airway remodelling were present in children with noneosinophilic asthma just as in those with eosinophilic disease. Indeed, compared with control children, both noneosinophilic and eosinophilic asthmatic children had thickened basement membrane, increased epithelial loss and higher number of vessels. Moreover, in both groups of asthmatics, expression of IL-4 and IL-5 was increased, while that of TGF-β receptor type II was reduced, compared with controls. This study demonstrates that structural changes typical of asthma develop in asthmatic children even in the absence of a prominent eosinophilic infiltrate, indicating that other mechanisms, besides eosinophilic inflammation, may promote airway remodelling early in life.
- Subjects :
- Age Factors
Basement Membrane metabolism
Bronchoscopy methods
Case-Control Studies
Child
Child, Preschool
Eosinophils pathology
Epithelium pathology
Female
Humans
Immunohistochemistry methods
Interleukin-4 metabolism
Interleukin-5 metabolism
Male
Neovascularization, Pathologic
Phenotype
Pulmonary Medicine methods
Airway Remodeling
Asthma pathology
Asthma therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1399-3003
- Volume :
- 38
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The European respiratory journal
- Publication Type :
- Academic Journal
- Accession number :
- 21310879
- Full Text :
- https://doi.org/10.1183/09031936.00168210