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Bronchoalveolar lavage findings suggest two different forms of childhood asthma

E C Stevenson1, G Turner, L G Heaney

  • 1Department of Clinical Biochemistry, The Queen's University of Belfast, UK.

Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology
|July 25, 1998
PubMed

Insights

Children with atopic asthma show ongoing airway inflammation during symptom-free periods, unlike those with viral wheeze. This indicates distinct underlying causes for wheezing in pediatric asthma patients.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Respiratory Medicine

Background:

  • Children with atopy and persistent asthma symptoms may have chronic airway inflammation.
  • Episodic wheezing in young children is often triggered by viral infections, with limited understanding of underlying inflammation during asymptomatic phases.
  • Investigating airway inflammation in different pediatric wheezing patterns is crucial for understanding disease mechanisms.

Purpose of the Study:

  • To investigate the cellular constituents of bronchoalveolar lavage (BAL) fluid in children with atopic asthma (AA), non-asthmatic atopic children (NAA), and viral-associated wheeze (VAW) during relatively asymptomatic periods.

Main Methods:

  • A non-bronchoscopic bronchoalveolar lavage (BAL) procedure was performed on 95 children undergoing elective surgery.
  • Cellular analysis of BAL fluid was conducted for children in three groups: AA (n=52), NAA (n=23), and VAW (n=20).
  • The study monitored for complications and adverse events related to the lavage procedure.

Main Results:

  • No complications or adverse events were reported post-procedure.
  • Total cell numbers in BAL fluid were higher in the viral-associated wheeze (VAW) group.
  • Eosinophil and mast cell counts were significantly elevated in children with atopic asthma (AA) compared to other groups.

Conclusions:

  • Children with atopic asthma exhibit ongoing airway inflammation, characterized by eosinophil and mast cell recruitment, even during asymptomatic periods.
  • Children with viral-associated wheeze (VAW) or atopy alone do not show this specific inflammatory pattern.
  • These findings suggest distinct pathophysiological mechanisms underlying atopic asthma and viral-induced wheezing in children.
Abstract

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