Nonatopic Children with Multitrigger Wheezing Have Airway Pathology Comparable to Atopic Asthma
| Autor: | Leonardo M. Fabbri, Piero Maestrelli, Graziella Turato, Kim Lokar-Oliani, Deborah Snijders, Simonetta Baraldo, Maria Elena Zanin, Marina Saetta, C. Panizzolo, Renzo Zuin, Angelo Barbato, Erica Bazzan, Fiorella Calabrese |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Hypersensitivity
Immediate Male Pulmonary and Respiratory Medicine Pathology medicine.medical_specialty Allergy Adolescent Bronchi Respiratory Mucosa Critical Care and Intensive Care Medicine Basement Membrane Atopy Th2 Cells Asthma physiopathology Wheeze Immunopathology Intensive care medicine Humans Child Respiratory Sounds Asthma Inflammation Neovascularization Pathologic business.industry Respiratory disease medicine.disease Immunohistochemistry Eosinophils El Niño Case-Control Studies Child Preschool Immunology Female Interleukin-4 Interleukin-5 medicine.symptom business |
| Zdroj: | American Journal of Respiratory and Critical Care Medicine. 178:476-482 |
| ISSN: | 1535-4970 1073-449X |
| DOI: | 10.1164/rccm.200712-1818oc |
| Popis: | Epidemiologic studies have shown that, in atopic children, wheezing is more likely to persist into adulthood, eventually becoming asthma, whereas it appears to resolve by adolescence in nonatopic children.To investigate whether among children with multitrigger wheeze responsive to bronchodilators the airway pathology would be different in nonatopic wheezers, who are often considered nonasthmatic, compared with atopic wheezers, who are more frequently diagnosed as having asthma.Bronchial biopsies were obtained from 55 children undergoing bronchoscopy for appropriate clinical indications: 18 nonatopic children with multitrigger wheeze (median age, 5 yr; range, 2-10 yr), 20 atopic children with multitrigger wheeze (medan age, 5 yr; range, 2-15 yr), and 17 control children with no atopy or wheeze (median age, 4; range, 2-14 yr). By histochemistry and immunohistochemistry, we quantified epithelial loss, basement membrane thickness, angiogenesis, inflammatory cells, IL-4(+,) and IL-5(+) cells in subepithelium.Unexpectedly, all pathologic features examined were similar in atopic and nonatopic wheezing children. Compared with control subjects, both nonatopic and atopic wheezing children had increased epithelial loss (P = 0.03 and P = 0.002, respectively), thickened basement membrane (both P0.0001), and increased number of vessels (P = 0.003 and P = 0.03, respectively) and eosinophils (P0.0001 and P = 0.002, respectively). Moreover, they had increased cytokine expression, which was highly significant for IL-4 (P = 0.002 and P = 0.0001, respectively) and marginal for IL-5 (P = 0.02 and P = 0.08, respectively).This study shows that the airway pathology typical of asthma is present in nonatopic wheezing children just as in atopic wheezing children. These results suggest that, when multitrigger wheezing responsive to bronchodilators is present, it is associated with pathologic features of asthma even in nonatopic children. |
| Databáze: | OpenAIRE |
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