Membrane Thickening Seen in Children With Difficult Asthma

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Basement Membrane Thickening Seen in Children With Difficult Asthma

NEW YORK (Reuters Health) Feb 04 - Thickening of the epithelial reticular

basement membrane (RBM) of airways occurs in children with difficult asthma

to a similar extent as that seen in adults with asthma, a multinational team

reports. " Remodeling of the airway wall occurs in adults with asthma, and RBM

thickening is pathognomonic of the asthma process, " Dr. K. of

Royal Brompton Hospital in London and colleagues note in the January 1st

issue of the American Journal of Respiratory and Critical Care Medicine.

However, objective measurements of RBM thickness in children with asthma are

lacking.Dr. 's team conducted a cross-sectional study to determine

whether RBM thickening is present in school-age children with difficult

asthma. They used light microscopy to measure RBM thickness in

plastic-embedded endobronchial biopsy specimens from 19 children with

difficult asthma requiring at least 1,600 g/day of inhaled steroids and in 10

asthma-free children. They did the same in three groups of adults as well: 8

healthy control subjects, 10 with mild steroid-nave asthma, and 6 adults

intubated after a life-threatening asthma attack, 3 of whom were steroid

nave.The team found that RBM thickness in the asthmatic children was similar

to that in adults with either mild or life-threatening asthma (median 8.2 vs.

8.1 and 7.2 m, respectively) and greater than either adult or pediatric

controls (4.4 and 4.9 m, respectively).There was no association between RBM

thickness and age, duration of symptoms, FEV1, or concurrent eosinophilic

inflammation.These findings confirm at least two previous reports that RBM

thickening " is a feature of asthma in children, " the investigators write.

They call for longitudinal studies in preschool-age children with asthma to

" determine when the RBM begins to thicken and whether this is dependent on

the prior establishment of chronic inflammation. " If these studies demonstrate

the presence of early and maximal RBM thickness in children, " this would lend

considerable support to the hypothesis that RBM thickening is a fundamental

component of airway pathology of asthma, " they write.Am J Respir Crit Care

2003;167:78-82. .

Becki

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