High-resolution computed tomography scan and airway remodeling in children with severe asthma - 18/08/11
, Isabelle Tillie-Leblond, MD, PhD b, Sophie Emond, MD c, Bruno Mahut, MD d, Thanh Lan Dang Duy, MD a, Pierre Scheinmann, MD a
Reprint requests: Professor Jacques de Blic, Service de Pneumologie et d’allergologie Pédiatriques, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75015 Paris, France.Paris and Lille, France
Abstract |
Background |
Children with severe asthma have a significantly higher bronchial wall thickness (BWT) on high-resolution computed tomography scan than control children.
Objective |
We sought to determine whether a BWT score correlates with markers of airway remodeling and inflammation.
Methods |
In 37 children with severe asthma, we determined reticular basement membrane thickness; number of intraepithelial neutrophils and eosinophils on bronchial biopsy; IFN-γ, IL-4, IL-5, and eosinophil cationic protein levels and IFN-γ/IL-4 ratio on bronchoalveolar lavage specimen; and alveolar nitric oxide (NO) concentration and the maximum airway wall NO flux.
Results |
The BWT score significantly correlated with reticular basement membrane thickening (r = 0.34; P = .04) and NO production by the airway wall (r = 0.45; P = .02). The correlation with the eosinophil cationic protein level was just significant (r = 0.40; P = .05), whereas there was no correlation with IFN-γ/IL-4 ratio (r = −0.31; P = .08). The BWT score did not correlate with FEV1 or forced expiratory flow at 25% to 75% of forced vital capacity.
Conclusion |
High-resolution computed tomography scan is a noninvasive technique that might be valuable for quantifying airway remodeling in children with severe asthma. The new generations of multislice computed tomography scanners will allow higher definition and lower radiation exposure and probably give a better assessment of airway remodeling and efficacy of treatment in children with asthma.
Le texte complet de cet article est disponible en PDF.Key words : Severe asthma, nitrous oxide, HRCT scan, bronchial wall thickening, reticular basement membrane, remodeling, airway inflammation, ECP, IFN-γ, IL-4
Abbreviations used : ATS, BWT, CalvNO, ECP, eNO, HRCT, J’awNO, NO, RBM
Plan
| Supported by a grant from GlaxoSmithKline, Paris. |
Vol 116 - N° 4
P. 750-754 - octobre 2005 Retour au numéro
Article précédent
- IgE antibody quantification and the probability of wheeze in preschool children
- Angela Simpson, Lars Soderstrom, Staffan Ahlstedt, Clare S. Murray, Ashley Woodcock, Adnan Custovic
- Failure of tacrolimus to prevent aspirin-induced respiratory reactions in patients with aspirin-exacerbated respiratory disease
- Donald D. Stevenson, Purvi K. Mehra, Andrew A. White, Sameer Gupta, Katherine M. Woessner, Ronald A. Simon
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?