Source: Annual Congress 2008 - Treatment and outcome of childhood asthma: new perspectives
Disease area: Airway diseases, Paediatric lung diseases

Abstract

Background: Thickening of the reticular basement membrane (RBM) is a hallmark of asthma, but it is unclear whether it contributes to harmful persistent airflow limitation (PAL) or is beneficial, reducing bronchoconstriction. We have previously reported in a small group of children with difficult asthma that pre- and post-bronchodilator FEV₁ do not correlate with thickening of the RBM [AJRCCM 2003; 167; 78-82]. In this study we aimed to evaluate whether RBM thickening is related to reversibility of airflow obstruction during a corticosteroid (CS) trial.
Methods: 65 children with severe asthma underwent fibreoptic bronchoscopy with endobronchial biopsy for measurement of RBM thickening, and a systemic corticosteroid trial. Lung function including pre- and post-bronchodilator FEV₁ was done before and after prednisolone (2 weeks of 40 mg/day, n= 35) or 2-4 weeks after a single dose of triamcinolone (80 mg, n=30).
Results: There was no correlation between FEV₁ (pre- or post-bronchodilator)_, and RBM thickness, measured either pre- or post-CS. 28 /52 (54%) of children showed a significant (>9% predicted) response in FEV₁ after CS, 24 did not. There was no significant difference in RBM thickness between the two groups (median 8,4um (IQ range 7,5-10,5) versus 8,1 um (6,9-9,2; p=0,2). There was also no difference in RBM in those with (n=17) or without (n=39) persistent airflow obstruction (FEV1 < 80%, post-bronchodilator and post-CS).
Conclusion: RBM thickness is not related to steroid sensitivity or persistent airflow limitation.

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Citations should be made in the following way:
C. Lex, L. Fleming, C. Bossley, N. Regamey, S. Saglani, A. G. Nicholson, D. N. Payne, N. M. Wilson, A. Bush (Halle/Saale, Germany; London, United Kingdom). Corticosteroid sensitivity, persistent airflow limitation and basement membrane thickening in children with asthma. Eur Respir J 2008; 32: Suppl. 52, 4593

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