Guillaume Lezmi1,2, Philippe Gosset3,4,5,6,7, Antoine Deschildre8, Rola Abou-Taam1, Bruno Mahut9, Nicole Beydon10, Jacques de Blic1,2. 1. 1 AP-HP, Hôpital Necker-Enfants Malades, Service de Pneumologie et d'Allergologie Pédiatriques, Paris, France. 2. 2 Université Paris Descartes, Paris, France. 3. 3 Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, Lille, France. 4. 4 Université Lille Nord de France, Lille, France. 5. 5 Centre National de la Recherche Scientifique, UMR 8204, Lille, France. 6. 6 Institut National de la Santé et de la Recherche Médicale, U1019, Lille, France. 7. 7 Institut Fédératif de la Recherche 142, Lille, France. 8. 8 Unité de Pneumologie-Allergologie Pédiatrique, Clinique de Pédiatrie Jeanne de Flandre, CHRU de Lille, Université Nord de France, Lille, France. 9. 9 Cabinet La Berma, Antony, France; and. 10. 10 APHP, Hôpital Armand Trousseau, Service d'Explorations Fonctionnelles Respiratoires, Paris, France.
Abstract
RATIONALE: Airway wall structure in preschoolers with severe recurrent wheeze is poorly described. OBJECTIVES: To describe airway wall structure and inflammation in preschoolers with severe recurrent wheeze. METHODS: Flexible bronchoscopy was performed in two groups of preschoolers with severe recurrent wheeze: group 1, less than or equal to 36 months (n = 20); group 2, 36-59 months (n = 29). We assessed airway inflammation, reticular basement membrane (RBM) thickness, airway smooth muscle (ASM), mucus gland area, vascularity, and epithelial integrity. Comparisons were then made with biopsies from 21 previously described schoolchildren with severe asthma (group 3, 5-11.2 yr). MEASUREMENTS AND MAIN RESULTS: RBM thickness was lower in group 1 than in group 2 (3.3 vs. 3.9 μm; P = 0.02), was correlated with age (P < 0.01; ρ = 0.62), and was higher in schoolchildren than in preschoolers (6.8 vs. 3.8 μm; P < 0.01). ASM area was lower in preschoolers than in schoolchildren (9.8% vs. 16.5%; P < 0.01). Vascularity was higher in group 1 than in group 2 (P = 0.02) and group 3 (P < 0.05). Mucus gland area was higher in preschoolers than in schoolchildren (16.4% vs. 4.6%; P < 0.01). Inflammatory cell counts in biopsies were not correlated with airway wall structure. ASM area was higher in preschoolers with atopy than without atopy (13.1% vs. 7.7%; P = 0.01). Airway morphometrics and inflammation were similar in viral and multiple-trigger wheezers. CONCLUSIONS: In preschoolers with severe recurrent wheeze, markers of remodeling and inflammation are unrelated, and atopy is associated with ASM. In the absence of control subjects, we cannot determine whether differences observed in RBM thickness and vascularity result from disease or normal age-related development.
RATIONALE: Airway wall structure in preschoolers with severe recurrent wheeze is poorly described. OBJECTIVES: To describe airway wall structure and inflammation in preschoolers with severe recurrent wheeze. METHODS: Flexible bronchoscopy was performed in two groups of preschoolers with severe recurrent wheeze: group 1, less than or equal to 36 months (n = 20); group 2, 36-59 months (n = 29). We assessed airway inflammation, reticular basement membrane (RBM) thickness, airway smooth muscle (ASM), mucus gland area, vascularity, and epithelial integrity. Comparisons were then made with biopsies from 21 previously described schoolchildren with severe asthma (group 3, 5-11.2 yr). MEASUREMENTS AND MAIN RESULTS: RBM thickness was lower in group 1 than in group 2 (3.3 vs. 3.9 μm; P = 0.02), was correlated with age (P < 0.01; ρ = 0.62), and was higher in schoolchildren than in preschoolers (6.8 vs. 3.8 μm; P < 0.01). ASM area was lower in preschoolers than in schoolchildren (9.8% vs. 16.5%; P < 0.01). Vascularity was higher in group 1 than in group 2 (P = 0.02) and group 3 (P < 0.05). Mucus gland area was higher in preschoolers than in schoolchildren (16.4% vs. 4.6%; P < 0.01). Inflammatory cell counts in biopsies were not correlated with airway wall structure. ASM area was higher in preschoolers with atopy than without atopy (13.1% vs. 7.7%; P = 0.01). Airway morphometrics and inflammation were similar in viral and multiple-trigger wheezers. CONCLUSIONS: In preschoolers with severe recurrent wheeze, markers of remodeling and inflammation are unrelated, and atopy is associated with ASM. In the absence of control subjects, we cannot determine whether differences observed in RBM thickness and vascularity result from disease or normal age-related development.
Authors: Hyun Jung Kwak; Dong Won Park; Ji-Young Seo; Ji-Yong Moon; Tae Hyung Kim; Jang Won Sohn; Dong Ho Shin; Ho Joo Yoon; Sung Soo Park; Sang-Heon Kim Journal: Exp Mol Med Date: 2015-12-11 Impact factor: 8.718