Correlation of bronchial eosinophil and mast cell activation with bronchial hyperresponsiveness in children with asthma.

Bronchial hyperresponsiveness in asthma has been associated with increased numbers of eosinophils and mast cells in the bronchial airway. It is unclear if these cells are important in the pathogenesis of hyperresponsiveness, and the role of mast cells has been discounted because they are effectively stabilized by beta-adrenergic drugs. Because the pathogenesis of asthma in children may be different from that in adults, and to find out if cellular activation is associated with bronchial reactivity, we studied 17 children with mild to moderately severe chronic asthma who had been treated with intermittent brochodilator therapy and compared their bronchial responsiveness to histamine with the levels of eosinophil cationic protein and mast cell tryptase in broncholavage fluid. The number of eosinophils in lavage fluid was correlated with histamine responsiveness (r = -0.444, p < 0.05) but not with levels of cationic protein (r = 0.33, p = NS). Bronchial responsiveness to histamine was highly correlated with mast cell tryptase (r = -0.714, p < 0.005), but there was no correlation with eosinophil cationic protein (r = -0.355, p = NS). We conclude that in children with chronic asthma mast cells as well as eosinophils contribute to bronchial hyperresponsiveness. Activated mast cells may play a primary role, possibly by tryptase-induced upregulation of bronchial smooth muscle tone.