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Airway structure and inflammatory cells in fatal attacks of asthma.
Eur Respir J. 1996 Apr; 9(4):709-15.ER

Abstract

Fatal attacks of asthma usually occur against a background of chronic persistent symptoms, presumably due to chronic airway inflammation and changes in airway wall structure. Death from asthma is usually attributed to excessive airway narrowing due to a combination of muscle spasm and mucous plugging. To test the hypothesis that airway wall structure and/or the inflammatory cell profile are related to the duration of a fatal attack of asthma, inflammatory cell profiles and airway structure were examined in cases of fatal asthma and related to the duration of the fatal attack. In transverse sections of large and small airways from subjects dying from asthma, the numbers of eosinophils, neutrophils and lymphomononuclear cells were counted. The amount of smooth muscle shortening, the areas of airway wall, smooth muscle, mucous gland and cartilage were measured. Cell counts, airway dimensions and muscle shortening were compared in cases dying within 2 h of the fatal attack (short duration) and those dying more than 5 h after the onset of the fatal attack (long duration). In cases with fatal attacks of short duration, the numbers of neutrophils and the mucous gland area were increased and the numbers of eosinophils were reduced compared to cases with fatal attacks of long duration. Lymphocyte numbers, airway wall thickness, the areas of smooth muscle and cartilage and the amount of smooth muscle shortening were similar in the two groups. These findings suggest fatal attacks of asthma may be triggered by an inflammatory stimulus and suggest that increased production of mucous may contribute to sudden death in such cases.

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Authors+Show Affiliations

Carroll N
Dept of Pulmonary Physiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia.
Carello S
No affiliation info available
Cooke C
No affiliation info available
James A
No affiliation info available

MeSH

AdolescentAdultAsthmaBronchiCartilageCell CountChildDeath, SuddenEosinophilsFemaleHumansInflammationLymphocyte CountLymphocytesMaleMiddle AgedMuscle, SmoothNeutrophilsTime Factors

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

8726935

Citation

Carroll, N, et al. "Airway Structure and Inflammatory Cells in Fatal Attacks of Asthma." The European Respiratory Journal, vol. 9, no. 4, 1996, pp. 709-15.
Carroll N, Carello S, Cooke C, et al. Airway structure and inflammatory cells in fatal attacks of asthma. Eur Respir J. 1996;9(4):709-15.
Carroll, N., Carello, S., Cooke, C., & James, A. (1996). Airway structure and inflammatory cells in fatal attacks of asthma. The European Respiratory Journal, 9(4), 709-15.
Carroll N, et al. Airway Structure and Inflammatory Cells in Fatal Attacks of Asthma. Eur Respir J. 1996;9(4):709-15. PubMed PMID: 8726935.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Airway structure and inflammatory cells in fatal attacks of asthma. AU - Carroll,N, AU - Carello,S, AU - Cooke,C, AU - James,A, PY - 1996/4/1/pubmed PY - 1996/4/1/medline PY - 1996/4/1/entrez SP - 709 EP - 15 JF - The European respiratory journal JO - Eur Respir J VL - 9 IS - 4 N2 - Fatal attacks of asthma usually occur against a background of chronic persistent symptoms, presumably due to chronic airway inflammation and changes in airway wall structure. Death from asthma is usually attributed to excessive airway narrowing due to a combination of muscle spasm and mucous plugging. To test the hypothesis that airway wall structure and/or the inflammatory cell profile are related to the duration of a fatal attack of asthma, inflammatory cell profiles and airway structure were examined in cases of fatal asthma and related to the duration of the fatal attack. In transverse sections of large and small airways from subjects dying from asthma, the numbers of eosinophils, neutrophils and lymphomononuclear cells were counted. The amount of smooth muscle shortening, the areas of airway wall, smooth muscle, mucous gland and cartilage were measured. Cell counts, airway dimensions and muscle shortening were compared in cases dying within 2 h of the fatal attack (short duration) and those dying more than 5 h after the onset of the fatal attack (long duration). In cases with fatal attacks of short duration, the numbers of neutrophils and the mucous gland area were increased and the numbers of eosinophils were reduced compared to cases with fatal attacks of long duration. Lymphocyte numbers, airway wall thickness, the areas of smooth muscle and cartilage and the amount of smooth muscle shortening were similar in the two groups. These findings suggest fatal attacks of asthma may be triggered by an inflammatory stimulus and suggest that increased production of mucous may contribute to sudden death in such cases. SN - 0903-1936 UR - https://www.unboundmedicine.com/medline/citation/8726935/Airway_structure_and_inflammatory_cells_in_fatal_attacks_of_asthma_ L2 - http://erj.ersjournals.com/cgi/pmidlookup?view=long&pmid=8726935 DB - PRIME DP - Unbound Medicine ER -