Am. J. Respir. Crit. Care Med., Vol 150, No. 3, 09 1994, 810-817.
Airway epithelial damage and inflammation in children with recurrent bronchitis
D Gaillard, JB Jouet, L Egreteau, L Plotkowski, JM Zahm, R Benali, D Pierrot and E Puchelle
Service de Pediatrie, American Memorial Hospital, Reims, France.
Inflammation and epithelial damage of the bronchial mucosa are frequently
identified in children with bronchial diseases. Nevertheless, until now the
quantitative assessment of the epithelial damage has never been studied in
relation to clinical or respiratory function or mucus abnormalities.
Bronchial biopsies and brushings were performed in 31 children with
recurrent bronchitis and without atopia. The quantitative histologic data
were compared with clinical results, the endoscopic appearance of the
mucosa, ciliary beating frequency, mucus transport capacity, leukocyte
count, and protein concentration in mucus samples. Most of the biopsies
(87%) collected in this group of children without recent acute infections
showed extensive epithelial damage. A significant correlation was observed
between the degree of shedding and edema (p < 0.01). Bronchial
epithelial edema was associated with a significantly decreased (p <
0.01) mucus transport rate. Inflammation of the submucosa was significantly
correlated with lymphocyte epithelial infiltration (p < 0.01), total
mucus protein content (p < 0.01), and local airway inflammation
estimated by bronchoscopy. These results demonstrate that children with
recurrent bronchitis develop a severe bronchial inflammation associated
with an increased mucus protein content and a reduction in the mucociliary
function.
