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Remodelling and inflammation in preschoolers with severe recurrent wheeze and asthma outcome at school age
Author(s) -
Lezmi G.,
Deschildre A.,
Abou Taam R.,
Fayon M.,
Blanchon S.,
Troussier F.,
Mallinger P.,
Mahut B.,
Gosset P.,
de Blic J.
Publication year - 2018
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.13143
Subject(s) - medicine , wheeze , asthma , neutrophilia , eosinophil , bronchial hyperresponsiveness , pediatrics , gastroenterology , lung , respiratory disease
Summary Background The influence of airway remodelling and inflammation in preschoolers with severe recurrent wheeze on asthma outcomes is poorly understood. Objective To assess their association with asthma symptoms and lung function at school age. Methods Preschoolers (38.4 months) initially investigated with bronchial biopsies were re‐assessed for asthma symptoms and lung function at school age. Results Thirty‐six of 49 preschoolers (73.5%) were assessed at 10.9 years. Twenty‐six (72.2%) had persistent asthma. Submucosal eosinophil counts were higher in children with severe exacerbations at school age than in those without (16/0.1 mm 2 [11.2‐30.4] vs 8/0.1 mm 2 [2.4‐17.6], P = .02), and correlated with the number of severe exacerbations ( P = .04, r = .35). Submucosal neutrophil counts correlated with FEV 1/ FVC ( P < .01, r = .47) and FEF 25‐75% predicted ( P = .02, r = .43). Airway smooth muscle ( ASM ) area correlated with FEV 1/ FVC ( P < .01, r = .51). Vessel numbers negatively correlated with FEV 1% predicted and FEV 1/ FVC ( P = .03, r = −.42; P = .04, r = −.41; respectively) and FEF 25‐75% predicted ( P = .02, r = −.46). Conclusion Eosinophilic inflammation in preschoolers with severe recurrent wheeze might be predictive of future severe exacerbations, neutrophilia might be associated with better lung function. Changes in ASM and vascularity might affect lung function at school age.