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Asthma, inflammation, eosinophils and bronchial hyperresponsiveness.

H Smith1

  • 1SmithKline Beecham Pharmaceuticals, Epsom, Surrey, U.K.

Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology
|February 1, 1992
PubMed
Summary

Asthma involves lung inflammation, not just blood eosinophilia. Cellular changes in the airways, like increased eosinophils and mast cells, are key, but their correlation with asthma severity remains unclear.

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Area of Science:

  • Immunology
  • Pulmonology
  • Cell Biology

Background:

  • Blood eosinophilia in asthmatics can correlate with disease severity.
  • However, elevated eosinophils in blood or BAL fluid do not always indicate asthma.
  • Lung-specific eosinophil activation is crucial for asthma pathology.

Purpose of the Study:

  • To investigate the role and localization of inflammatory cells in asthma.
  • To examine cellular changes in bronchoalveolar lavage (BAL) fluid and bronchial biopsies of asthmatics.
  • To explore the correlation between these cellular changes and asthma severity, lung function, and bronchial hyperresponsiveness.

Main Methods:

  • Analysis of differential cell counts in BAL fluid from asthmatics.
  • Examination of bronchial biopsies for cellular infiltration and mucosal changes.

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  • Assessment of correlations between cellular findings and clinical parameters like asthma severity and bronchial responsiveness.

    • Main Results:

    • BAL fluid shows increased mast cells and eosinophils, with potential increases in lymphocytes and epithelial cells, and decreased macrophages.
    • Bronchial biopsies reveal increased mast cells, eosinophils, and lymphocytes in the mucosa, along with epithelial shedding and sub-basement membrane thickening.
    • Correlations between cellular changes and asthma severity or lung function were inconsistent.
    • Inhaled steroid treatment reduced cellular infiltration but had minimal impact on bronchial responsiveness.

    Conclusions:

    • Inflammatory cell infiltration in the lung, particularly eosinophils and mast cells, is characteristic of asthma.
    • The presence and activation of these cells in the lung, rather than blood, are critical for asthma.
    • Intermittent inflammation may lead to long-lasting bronchial hyperresponsiveness, even in mild asthma.