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Functional analysis of airway remodeling is related with fibrotic mediators in asthmatic children
Lucas P Salles-Dias1, Maysa A R Brandao-Rangel2, Amanda Cristina-Rosa2
1Post-graduate Program in Bioengineering, Universidade Brasil, São Paulo, SP, Brazil.
Insights
In asthmatic children, increased airway resistance correlates with higher levels of pro-inflammatory and pro-fibrotic mediators. Impulse oscillometry effectively detects this resistance, aiding in understanding asthma severity.
Area of Science:
- Pediatric Pulmonology
- Immunology
- Respiratory Medicine
Background:
- Asthma in children involves variable airway inflammation, remodeling, and resistance, impacting disease control and severity.
- Chronic airway inflammation leads to remodeling, which directly correlates with increased airway resistance.
- Pro-inflammatory and pro-fibrotic mediators play a crucial role in the pathogenesis of airway remodeling and resistance.
Purpose of the Study:
- To determine the correlation between pulmonary and systemic pro-inflammatory and pro-fibrotic mediator levels and respiratory system resistance in asthmatic children.
- To investigate the relationship between mediator levels and resistance in both proximal and distal airways.
Main Methods:
- Evaluated 39 persistent mild-to-moderate asthmatic children and 39 non-asthmatic controls (ages 6-13).
- Assessed anthropometric characteristics, lung function, and mechanics using impulse oscillometry.
- Measured pulmonary and systemic immune responses, including inflammatory factors in breath condensate and serum.
Main Results:
- Asthmatic children exhibited higher blood eosinophils, basophils, monocytes, and lymphocytes.
- Impaired lung function in asthmatics included reduced FEV1 and FEV1/FVC, decreased total respiratory resistance (R5Hz), increased proximal airway resistance (R20Hz), and altered elastance (Z5Hz) and reactance (X5Hz).
- Significantly elevated levels of GM-CSF, TGF-beta, IL-5, and IL-4 were found in asthmatic children's breath condensate and/or serum compared to controls.
Conclusions:
- Impulse oscillometry is a sensitive tool for detecting airway resistance in children with persistent mild and moderate asthma.
- Increased airway resistance in these children is associated with elevated levels of pro-inflammatory and pro-fibrotic mediators.
- These findings highlight the link between inflammatory mediators and airway mechanics in pediatric asthma.
Background:
Asthmatic children present variable degrees of airway inflammation, remodeling, and resistance, which correlate with disease control and severity. The chronic inflammatory process of the airway triggers airway remodeling, which reflects the degree of airway resistance. Pro-inflammatory and pro-fibrotic mediators are centrally involved in this process.
Objective:
To investigate whether the levels of pulmonary and systemic pro-inflammatory and pro-fibrotic mediators present a correlation with the resistance of the respiratory system and of the proximal and distal airways.
Methods:
39 Asthmatic children (persistent mild and moderate) and 39 non-asthmatic children (both between 6 and 13 years old) were evaluated for anthropometric characteristics, lung function and mechanics, and pulmonary and systemic immune responses.
Results:
Asthmatic children showed an increased number of blood eosinophils (p < 0.04), basophils (p < 0.04), monocytes (p < 0.002) and lymphocytes (p < 0.03). In addition, asthmatic children showed impaired lung function, as demonstrated by FEV1 (p < 0.0005) and FEV1/FVC (p < 0.004), decreased total resistance of the respiratory system (R5Hz; p < 0.009), increased resistance of the proximal airways (R20Hz; p < 0.02), increased elastance (Z5Hz; p < 0.02) and increased reactance (X5Hz; p < 0.002) compared to non-asthmatic children. Moreover, the following inflammatory factors were significantly higher in asthmatic than non-asthmatic children: GM-CSF in the breath condensate (BC) (p < 0.0001) and in the serum (p < 0.0001); TGF-beta in the BC (p < 0.0001) and in the serum (p < 0.004); IL-5 in the BC (p < 0.02) and in the serum (p < 0.01); IL-4 in the serum (p < 0.0002).
Conclusions:
Impulse oscillometry is a sensitive method to detect airway resistance in persistent mild and moderate asthmatic children, an event followed by increased levels of pro-inflammatory and pro-fibrotic mediators.
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