Increased airway smooth muscle in preschool wheezers who have asthma at school age - 30/03/13
Corresponding author: Sejal Saglani, MD, Leukocyte Biology, National Heart and Lung Institute, Imperial College London, Exhibition Road, London SW7 2AZ, United Kingdom.Abstract |
Background |
Increased airway smooth muscle (ASM) is a feature of established asthma in schoolchildren, but nothing is known about ASM in preschool wheezers.
Objective |
We sought to determine endobronchial biopsy specimen ASM area fraction in preschool wheezers and its association with asthma at school age.
Methods |
ASM area, reticular basement membrane thickness, and mucosal eosinophil and ASM mast cell values were quantified in endobronchial biopsy specimens previously obtained from preschool children undergoing clinically indicated bronchoscopy: severe recurrent wheezers (n = 47; median age, 26 months) and nonwheezing control subjects (n = 21; median age, 15 months). Children were followed up, and asthma status was established at age 6 to 11 years. Preschool airway pathology was examined in relation to asthma at school age.
Results |
Forty-two (62%) of 68 children had 1 or more evaluable biopsy specimens for ASM. At school age, 51 of 68 children were followed up, and 15 (40%) of 37 preschool wheezers had asthma. Children who had asthma and an evaluable biopsy specimen had increased preschool ASM area fraction (n = 8; median age, 8.2 years [range, 6-10.4 years]; median ASM, 0.12 [range, 0.08-0.16]) compared with that seen in children without asthma (n = 24; median age, 7.3 years [range, 5.9-11 years]; median ASM, 0.07 [range, 0.02-0.23]; P = .007). However, preschool reticular basement membrane thickness and mucosal eosinophil or ASM mast cell values were not different between those who did or did not have asthma at school age.
Conclusion |
Increased preschool ASM is associated with those children who have asthma at school age. Thus a focus on early changes in ASM might be important in understanding the subsequent development of childhood asthma.
Le texte complet de cet article est disponible en PDF.Key words : Preschool wheeze, airway smooth muscle, asthma, pediatric, pathology
Abbreviations used : ASM, EB, Feno50, FRC, RBM, ROC, Scond, SPT
Plan
| R. O’Reilly and S. Saglani were both supported by an Asthma UK project grant. S. Saglani was supported by a Clinical Intermediate Fellowship from the Wellcome Trust, United Kingdom. The project was supported by the National Institute for Health Research Respiratory Disease Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London. |
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| Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest. |
Vol 131 - N° 4
P. 1024 - avril 2013 Retour au numéro
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