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Epithelial damage and angiogenesis in the airways of children with asthma

Angelo Barbato1, Graziella Turato, Simonetta Baraldo

  • 1Divisione di Pneumologia, Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari Università degli Studi di Padova, via Giustiniani 3, Padova, Italy.

American Journal of Respiratory and Critical Care Medicine
|August 19, 2006
PubMed

Insights

Childhood asthma shows airway remodeling, including epithelial damage and thickened basement membranes, similar to adults. These changes, along with eosinophilia, appear early in the disease and may also indicate atopy without asthma symptoms.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Immunology

Background:

  • Airway remodeling and inflammation are hallmarks of adult asthma.
  • These pathological features are under-investigated in pediatric asthma cases.

Purpose of the Study:

  • To investigate epithelial and vascular changes in pediatric asthma.
  • To assess the inflammatory response within the airways of children with asthma.

Main Methods:

  • Analysis of bronchial biopsies from 44 children (17 mild/moderate asthma, 12 atopy without asthma, 15 controls).
  • Histochemistry and immunohistochemistry used to quantify epithelial loss, basement membrane thickness, vascularity, and inflammatory cells.
  • Stratified analysis by age was performed.

Main Results:

  • Children with asthma exhibited increased epithelial loss and basement membrane thickness compared to controls and atopic children.
  • Increased vascularity and eosinophils were observed in both asthmatic and atopic children without asthma, compared to controls.
  • Younger children (<6 years) with asthma showed significantly increased epithelial loss, basement membrane thickening, and eosinophilia.

Conclusions:

  • Pathological airway changes, characteristic of adult asthma, are present even in childhood asthma.
  • Airway eosinophilia and increased vascularity (angiogenesis) were also noted in atopic children without asthma.
  • These findings suggest that airway lesions develop early in asthma's natural history and may be indicative of atopy, even before asthma symptoms manifest.
Abstract

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