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Published on: August 7, 2017
Structural changes in the bronchial mucosa of young children at risk of developing asthma
Katarina Berankova1, Jiri Uhlik, Lenka Honkova
1Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Insights
Early childhood asthma may begin with subtle airway changes before symptoms appear. Research shows differences in basement membrane thickness and glycoproteins in children at risk for asthma.
Area of Science:
- Pediatric Pulmonology
- Cellular Biology
- Immunology
Background:
- Childhood asthma onset is linked to airway inflammation.
- Airway remodeling is common in adult asthmatics, but its early development is poorly understood.
- This study investigates early histological changes in young children predisposed to asthma.
Purpose of the Study:
- To identify early morphological changes in the bronchial mucosa of children at risk for asthma.
- To investigate the onset of airway remodeling in pre-symptomatic asthmatic children.
- To determine if early epithelial changes precede clinical asthma manifestation.
Main Methods:
- Histological analysis of bronchial biopsies from children under 4 years old.
- Measurement of basement membrane thickness via light microscopy.
- Immunohistochemical analysis of basement membrane glycoproteins (laminin, tenascin, collagen IV).
- Comparison between children meeting Asthma Predictive Index criteria and a control group.
Main Results:
- Significant differences in basement membrane thickness were observed between groups.
- Altered subepithelial deposition of laminin and collagen IV was found in children predisposed to asthma.
- No significant difference in tenascin deposition was detected.
Conclusions:
- Airway remodeling processes may initiate in early childhood, preceding clinical asthma diagnosis.
- Subtle changes in the airway basement membrane are detectable in very young children at risk for asthma.
- These early histological alterations suggest a potential mechanism for asthma development from a young age.
Background:
Bronchial asthma often starts in early childhood. Clinical manifestation of the disease is likely due to inflammatory processes in the airways initiated by various stimuli. Developed remodelling is regularly observed in the bronchial mucosa of adult asthmatics but we still lack information about its onset and latter development with the natural course of the disease. In this study, we analysed histological findings in bronchial biopsies obtained from very young children (under 4 yr of age). We hypothesized that initial undetectable changes in the airway epithelium of children predisposed to asthma may be one of the first mechanisms leading to morphological changes in the bronchial mucosa.
Methods:
We measured the thickness of the basement membrane using a light microscope and analysed the presence of its three basic structural glycoproteins: laminin, tenascin and collagen IV, using immunohistochemical techniques. We compared these findings in children predisposed to asthma according to the selected clinical criteria of the Asthma Predictive Index and in a control group of children.
Results:
We found a significant difference in the thickness of the basement membrane between the two groups. We also found a difference in the subepithelial deposition of laminin and collagen IV in the basement membrane but no difference in the deposition of tenascin.
Conclusions:
We conclude that initial changes leading to further remodelling may start at a very early age even before clinical manifestation of the disease.
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