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Long-term pathologic consequences of acute irritant-induced asthma
Naoya Takeda1, Karim Maghni, Sylvie Daigle
1Meakins-Christie Laboratories, McGill University, Montreal, Quebec, Canada.
The Journal of Allergy and Clinical Immunology
|November 10, 2009
Summary
Long-term consequences of acute irritant-induced asthma (IrIa) include persistent airway inflammation and remodeling. This study found significant eosinophilic and neutrophilic inflammation years after an inhalational accident in IrIa patients.
Area of Science:
- Pulmonology
- Immunology
- Pathology
Background:
- Acute irritant-induced asthma (IrIa), also known as reactive airways dysfunction syndrome, results from high-concentration agent exposure.
- The chronic pathological effects of IrIa have not been well-established.
Purpose of the Study:
- To investigate chronic airway inflammation and remodeling in individuals with a history of IrIa.
- To compare immunologic and morphologic data of IrIa patients with asthma patients and healthy controls.
Main Methods:
- Bronchoscopy, bronchoalveolar lavage, and bronchial biopsies were performed on ten IrIa subjects (mean 10.9 years post-accident).
- Immunologic and morphologic analyses were conducted and compared to mild-to-moderate asthma patients and healthy controls.
Main Results:
- IrIa patients showed increased eosinophils and neutrophils in bronchoalveolar lavage fluid.
- Elevated levels of eosinophilic cationic protein, IL-8, FGF, and MMP-1 were observed in IrIa patients.
- Significant subepithelial fibrosis (basement membrane thickening) was found in IrIa patients, correlating with airway hyperresponsiveness (PC20).
- Increased eosinophil cationic protein and TGF-β1-positive cells were noted in IrIa patients.
Conclusions:
- This study demonstrates persistent eosinophilic and neutrophilic airway inflammation in IrIa patients many years after the initial inhalational exposure.
- Evidence of airway remodeling, specifically subepithelial fibrosis, is present long-term in IrIa.
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