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Published ahead of print on July 31, 2003, doi:10.1164/rccm.200305-650OC

Am. J. Respir. Crit. Care Med., Volume 168, Number 7, October 2003, 798-803

A more recent version of this article appeared on October 1, 2003
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Submitted on May 23, 2003
Accepted on July 26, 2003

Airway inflammation in childhood asthma

Angelo Barbato1, Graziella Turato2, Simonetta Baraldo3, Erica Bazzan3, Fiorella Calabrese4, Maria Tura1, Renzo Zuin3, Bianca Beghe3, Piero Maestrelli5, Leonardo M Fabbri6, and Marina Saetta3*

1 Paediatrics, University of Padova, Padova, Italy, 2 Clinical and Experimental Medicine, University of Padova, Padova, Italy; Respiratory Diseases and Radiology, University of Modena and Reggio Emilia, Modena, Italy, 3 Clinical and Experimental Medicine, University of Padova, Padova, Italy, 4 Institute of Pathology, University of Padova, Padova, Italy, 5 Environmental Medicine and Public Health, University of Padova, Padova, Italy, 6 Respiratory Diseases and Radiology, University of Modena and Reggio Emilia, Modena, Italy

* To whom correspondence should be addressed. E-mail: marina.saetta{at}unipd.it.

Airway pathology has been extensively investigated in adulthood asthma, while only few studies examined bronchial biopsies in childhood asthma. To evaluate the airway pathology in asthmatic children we analyzed bronchial biopsies obtained from 23 children undergoing bronchoscopy for clinical indications other than asthma. Nine had mild/moderate asthma, 6 had atopy without asthma and 8 had no atopy nor 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 {beta}1 (TGF{beta}1) and its receptors I and II (TGF{beta}-RI and TGF{beta}-RII) in subepithelium. Asthmatic children had an increase in basement membrane thickness and in number of eosinophils compared to controls, but not compared to atopic children. They also had a decreased expression of TGF{beta}-RII compared to both atopics and controls. In asthmatic children the number of eosinophils correlated negatively with TGF{beta}-RII and positively with symptom duration. In conclusion, airway eosinophilia and basement membrane thickening, which are the pathologic features characteristic of adulthood asthma, are already present in children with mild asthma, and even in atopic children without asthma. Moreover in asthmatic, but not in atopic non asthmatic children, there is a downregulation of TGF{beta}receptor II.
Key words: inflammation, remodelling, paediatric asthma, cytokines




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