Early thickening of the reticular basement membrane in children with difficult asthma
Early thickening of the reticular basement membrane in children with difficult asthma
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DOI：
10.1164/rccm.200205-414oc
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发表时间：
2003-01-01
影响因子：
24.7
通讯作者：
Jeffery, PK
中科院分区：
文献类型：
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作者：
Payne, DNR;Rogers, AV;Jeffery, PK
成人哮喘患者会发生气道壁重塑，网状基底膜(RBM)增厚是哮喘过程的病因学特征。为了研究难治性哮喘儿童是否存在RBM增厚，并与成人哮喘患者相比较，我们使用光学显微镜测量了19例难治性哮喘儿童(年龄范围6-16岁)、10名非哮喘儿童(7-16岁)和3名成人组(8名健康对照组(21-42岁)，10名轻度类固醇幼稚哮喘患者(18-41岁))塑料床支气管内活检切片的RBM厚度。6名成人(3名未服用类固醇，3名吸入类固醇)因哮喘发作(20-)而需插管。哮喘儿童的RBM厚度与轻度哮喘或危及生命的成人相似(中位数分别为8.2[范围5.4-11.1]比8.1[5.8-10.0]和7.2[2.8-10.01]微米)，并高于成人或儿童对照组(8.2[5.4-11.1]微米和4.4[3.2-6.3]微米，p<；0.01和4.9[3.7-8.3]微米，p<；0.01和4.9[3.7-8.3]微米；0.01)。我们得出结论，在患有难治性哮喘的儿童中已经存在RBM增厚，其程度与成人哮喘相似。此外，我们发现与年龄、症状持续时间、肺功能或并发嗜酸性气道炎无关。
Remodeling of the airway wall occurs in adults with asthma, and reticular basement membrane (RBM) thickening is pathognomonic of the asthma process. To investigate whether RBM thickening is present in children with difficult asthma and comparable to that seen in adults with asthma, we used light microscopy to measure RBM thickness in plastic-em bedded endobronchial biopsy sections from 19 children with difficult asthma who were prescribed 1,600 mug/day or more of inhaled steroids (age range, 6-16 years), 10 children without asthma (7-16 years), and three adult groups: 8 healthy control subjects (21-42 years), 10 mild steroid-naive subjects with asthma (18-41 years), and 6 adults (3 steroid naive and 3 on inhaled steroids) intubated after a life-threatening attack of asthma (20-64 years). RBM thickness in the children with asthma was similar to that in adults with either mild or life-threatening asthma (median 8.2 [range 5.4-11.1] versus 8.1 [5.8-10.0] and 7.2 [2.8-10.01] mum, respectively) and greater than either adult or pediatric control subjects (8.2 [5.4-11.1] versus 4.4 [3.2-6.3] mum, p < 0.01, and 4.9 [3.7-8.3] mum, p < 0.01). We conclude that RBM thickening is already present in children with difficult asthma and to a similar extent to that seen in adults with asthma. In addition, we find no association with age, symptom duration, lung function, or concurrent eosinophilic airway inflammation.