Airway eosinophilia in remission and progression of asthma: Accumulation with a fast decline of FEV1

作者：Broekema M; Volbeda F; Timens W; Dijkstra A; Lee N A; Lee J J; Lodewijk M E; Postma D S; Hylkema M N; ten Hacken N H T^*

来源：Respiratory Medicine, 2010, 104(9): 1254-1262.

DOI：10.1016/j.rmed.2010.03.030

• Airway inflammation
• Airway remodeling
• Lung function decline
• Eosinophils

Background: As it is unknown whether complete asthma remission or progression of asthma is associated with airway inflammation and remodeling, we assessed these characteristics in bronchial biopsies of relevant subsets of asthma patients.
Methods: Sputum and bronchial biopsies were obtained from asthma patients in remission (PC20 histamine > 32 mg/ml, PC20 AMP > 320 mg/ml) and from those with either a slow FEV1 decline (<30 ml/year) or fast decline (>30 ml/year). Inflammatory cells and mediators were determined in sputum, inflammatory cells and aspects of airway remodeling in bronchial biopsies.
Results: Asthmatics in remission and asthma patients with a slow FEV1 decline had a similar extent of airway inflammation and remodeling in sputum and bronchial biopsies. Asthma patients with a fast FEV1 decline had high sputum eosinophil numbers. Moreover, FEV1 decline (ml/year) correlated with sputum eosinophil numbers (Rs = 0.51, p = 0.003) and ECP levels (Rs = 0.57, p = 0.001). Airway remodeling, i.e. basement membrane thickness, correlated with sputum eosinophils (Rs = 0.69, p < 0.001), sputum ECP (Rs = 0.46, p = 0.018) and airway wall eosinophil numbers (Rs = 0.49, p = 0.002).
Conclusions: Asthma, even when in remission, is accompanied by airway inflammation and remodeling. Data suggest that eosinophils are important in a subset of asthma patients by association to accelerated FEV1 decline and change of basement membrane thickness.

• 出版日期2010-9