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Airway remodeling is correlated with obstruction in children with severe asthma.
Allergy. 2008 May; 63(5):533-41.A

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 (FEV(1)) 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). FEV(1) 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.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Tillie-Leblond I
Unité INSERM U 774, Institut Pasteur de Lille, Lille, France.
de Blic J
No affiliation info available
Jaubert F
No affiliation info available
Wallaert B
No affiliation info available
Scheinmann P
No affiliation info available
Gosset P
No affiliation info available

MeSH

AdolescentAirway ObstructionAsthmaBiopsyBronchiChildChild, PreschoolFemaleForced Expiratory VolumeHumansMaleMuscle, SmoothRespiratory MucosaSeverity of Illness Index

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18394127

Citation

Tillie-Leblond, I, et al. "Airway Remodeling Is Correlated With Obstruction in Children With Severe Asthma." Allergy, vol. 63, no. 5, 2008, pp. 533-41.
Tillie-Leblond I, de Blic J, Jaubert F, et al. Airway remodeling is correlated with obstruction in children with severe asthma. Allergy. 2008;63(5):533-41.
Tillie-Leblond, I., de Blic, J., Jaubert, F., Wallaert, B., Scheinmann, P., & Gosset, P. (2008). Airway remodeling is correlated with obstruction in children with severe asthma. Allergy, 63(5), 533-41. https://doi.org/10.1111/j.1398-9995.2008.01656.x
Tillie-Leblond I, et al. Airway Remodeling Is Correlated With Obstruction in Children With Severe Asthma. Allergy. 2008;63(5):533-41. PubMed PMID: 18394127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Airway remodeling is correlated with obstruction in children with severe asthma. AU - Tillie-Leblond,I, AU - de Blic,J, AU - Jaubert,F, AU - Wallaert,B, AU - Scheinmann,P, AU - Gosset,P, PY - 2008/4/9/pubmed PY - 2008/5/30/medline PY - 2008/4/9/entrez SP - 533 EP - 41 JF - Allergy JO - Allergy VL - 63 IS - 5 N2 - 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 (FEV(1)) 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). FEV(1) 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. SN - 1398-9995 UR - https://www.unboundmedicine.com/medline/citation/18394127/Airway_remodeling_is_correlated_with_obstruction_in_children_with_severe_asthma_ DB - PRIME DP - Unbound Medicine ER -