Source: International Congress 2014 – New mechanisms in the pathogenesis of asthma and other lung diseases
Disease area: Airway diseases

Abstract

BackgroundIn asthma the association between airway inflammation, airway remodelling, determined in bronchial biopsies; and lung physiology is unclear.MethodsPatients with moderate-to-severe persistent asthma and sputum eosinophilia (>2%) underwent endobronchial sampling, spirometry, lung plethysmography and impulse oscillometry. Airway biopsies were examined for airway smooth muscle (ASM) content (ASM%), reticular basement membrane (RBM) thickness and inflammatory cells counts (cells/mm² of submucosa) for eosinophils, T-lymphocytes, neutrophils and mast cells.Results34 patients were recruited. ASM% was negatively correlated with both pre-bronchodilator (r_s= -0.446, p=0.008) and post-bronchodilator FEV₁/FVC and (r_s= -0.445, p=0.008); but no correlation with oscillometry indices or inflammatory cell counts. RBM thickness did not correlate with submucosal inflammatory cell counts or physiological indices. Submucosal eosinophils were positively correlated with CO transfer coefficient (KCO) (r_s= 0.381, p=0.026), and R5 (r_s= 0.441, p=0.009).



Conclusion Increased ASM% and submucosal eosinophils were associated with airflow obstruction and resistance respectively. Whether resistance measures are a sensitive measure of response to anti-eosinophilic therapies requires further study.Acknowledgements: Work funded by Novartis Pharmaceuticals.

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R. Berair, S. Gonem, V. Mistry, A. Singapuri, N. Rana, R. Kay, S. Siddiqui, C. Brightling (Leicester, United Kingdom; Basel, Switzerland). Association between airway inflammation, airway remodelling and physiological changes in asthma. Eur Respir J 2014; 44: Suppl. 58, 3865

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