Airway inflammation in childhood asthma
Airway inflammation in childhood asthma
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DOI：
10.1164/rccm.200305-650oc
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发表时间：
2003-10-01
影响因子：
24.7
通讯作者：
Saetta, M
中科院分区：
文献类型：
--
作者：
Barbato, A;Turato, G;Saetta, M
气道病理学已在成人哮喘中得到广泛研究，而只有少数研究对儿童哮喘中的支气管活检进行了检查。为了评估哮喘儿童的气道病理学，我们分析了 23 名接受支气管镜检查的儿童的支气管活检，以了解哮喘以外的临床指征。九人患有轻度/中度哮喘。六名有特应性但没有哮喘，八名没有特应性或哮喘。我们测量了基底膜厚度，并对嗜酸性粒细胞、肥大细胞、中性粒细胞、巨噬细胞、T 淋巴细胞和转化生长阳性细胞的数量进行了定量。上皮下的因子-β1 (TGF-β1) 及其受体 I 和 11（TGFbeta-RI 和 TGFbeta-RII）。与对照组相比，哮喘儿童的基底膜厚度和嗜酸性粒细胞数量有所增加，但与特应性儿童相比则没有增加。与特应性受试者和对照受试者相比，他们的 TGFbeta-RII 表达也有所降低。在患有哮喘的儿童中，嗜酸性粒细胞的数量与 TGFbeta-RII 呈负相关，与症状持续时间呈正相关。总之，气道嗜酸性粒细胞和基底膜增厚是成年期哮喘的病理特征，在轻度哮喘儿童甚至非哮喘特应性儿童中已经存在。此外，在患有哮喘的儿童中，但在没有哮喘的特应性儿童中，TGFbeta-RII 存在下调。
Airway pathology has been extensively investigated in adulthood asthma, whereas only few studies examined bronchial biopsies in childhood asthma. To evaluate the airway pathology in children with asthma, we analyzed bronchial biopsies obtained from 23 children undergoing bronchoscopy for clinical indications other than asthma. Nine had mild/moderate asthma. Six had atopy without asthma, and eight had no atopy or asthma. We measured basement membrane thickness and quantified the number of eosinophils, mast cells, neutrophils, macrophages, T lymphocytes, and positive cells for transforming growth. factor-beta1 (TGF-beta1) and its receptors I and 11 (TGFbeta-RI and TGFbeta-RII) in subepithelium. Children with asthma had an increase in basement membrane thickness and in the number of eosinophils compared with control subjects, but not compared with children with atopy. They also had a decreased expression of TGFbeta-RII compared with both those with atopy and control subjects. In children with asthma, the number of eosinophils correlated negatively with TGFbeta-RII and positively with symptom duration. In conclusion, airway eosinophilla and basement membrane thickening, which are the pathologic features that are characteristic of adulthood asthma, are already present in children with mild asthma, and even in children with atopy without asthma. Moreover, in children with asthma but not in children with atopy without asthma, there is a downregulation of TGFbeta-RII.