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Updated: Jul 8, 2026
07:45
Modeling Dysplastic and Functional Lung Alveolar Repair after Influenza Infection
Published on: September 19, 2025
How early do airway inflammation and remodeling occur?
1Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK. a.bush@rbh.nthames.nhs.uk
Summary
Early airway inflammation in infants, characterized by neutrophils, precedes eosinophilic inflammation and structural changes seen in preschool asthmatics. The preschool years are a critical window for intervention to potentially improve long-term asthma outcomes.
Area of Science:
- Pediatric Respiratory Medicine
- Asthma Pathophysiology
- Airway Remodeling
Background:
- Asthma involves eosinophilic airway inflammation and structural changes, but their onset and relationship are debated.
- Early wheezing infants show no eosinophilic inflammation or reticular basement membrane (RBM) thickening, which appear by age three.
- Persistent wheezing is linked to pre-school lung function decline, suggesting this period is crucial for intervention.
Purpose of the Study:
- To investigate the temporal relationship between airway inflammation and structural changes in early childhood asthma.
- To identify key inflammatory cells and processes in early wheezing and their link to asthma development.
- To determine the significance of the pre-school years as a window for therapeutic intervention in asthma.
Main Methods:
- Analysis of airway inflammation markers (eosinophils, neutrophils) and structural changes (RBM thickening) in wheezing infants and young children.
- Review of cohort studies correlating early wheezing with pre-school lung function.
- Examination of blood and bronchoalveolar lavage fluid to identify inflammatory cell involvement.
Main Results:
- Eosinophilic inflammation and RBM thickening are absent in one-year-olds but present by three years in wheezing children.
- Neutrophils appear to be the primary inflammatory cells in early wheeze.
- Lung function decline in persistent wheezers occurs in the pre-school years.
Conclusions:
- The preschool years represent a critical window for intervention in asthma, as structural and inflammatory changes become established.
- Early wheezing pathophysiology involves a shift from neutrophil-driven inflammation to eosinophilic inflammation and airway remodeling.
- Understanding the sequence of events in early asthma is key to developing effective, long-term treatment strategies.
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