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Published ahead of print on March 24, 2004, doi:10.1164/rccm.200401-123OC

Am. J. Respir. Crit. Care Med., Volume 169, Number 10, May 2004, 1125-1130

A more recent version of this article appeared on May 15, 2004
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Submitted on February 4, 2004
Accepted on March 19, 2004

Role of Microvascular Permeability on Physiologic Differences in Asthma and Eosinophilic Bronchitis

Hiroshi Kanazawa1*, Saeko Nomura1, and Junichi Yoshikawa1

1 Department of Respiratory Medicine, Osaka City University, Osaka, Japan

* To whom correspondence should be addressed. E-mail: kanazawa-h{at}med.osaka-cu.ac.jp.

Asthma and eosinophilic bronchitis are characterized by similar type of eosinophilic inflammation. However, eosinophilic bronchitis differs from asthma in that there is no variable airflow obstruction or airway hyperresponsiveness. We evaluated the roles of vascular endothelial growth factor (VEGF) and microvascular permeability in causing these differences between the two diseases. Inflammatory indexes in induced sputum, exhaled nitric oxide (NO) levels, and vascular permeability index were examined in 11 normal controls, 19 beclomethasone dipropionate (BDP)-treated asthmatics, 20 BDP-nontreated asthmatics, and 17 patients with eosinophilic bronchitis. The percentage of eosinophils in sputum and exhaled NO levels were significantly higher in BDP-nontreated asthmatics and patients with eosinophilic bronchitis than in other two groups. However, VEGF levels and vascular permeability index were significantly higher in BDP-nontreated (VEGF: 4710 (1150) pg/mL, p<0.0001; vascular permeability index: 0.028 (0.009), p<0.0001) and -treated (2560 (1070) pg/mL, p=0.0002; 0.016 (0.006), p=0.004) asthmatics than in patients with eosinophilic bronchitis (1120 (800) pg/mL; 0.01 (0.005)) and normal controls (1390 (1280) pg/mL; 0.008 (0.003)). We found significant correlations between VEGF level and airway vascular permeability index in all patient groups. Thus, interaction between airway microcirculation and VEGF may be a key element in differences in airway function between asthma and eosinophilic bronchitis.
Key words: airway hyperresponsiveness, microvascular leakage, sputum eosinophilia, vascular endothelial growth factor, variable airflow obstruction




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