Airway remodeling in subjects with severe asthma with or without chronic persistent airflow obstruction

The patterns of airway remodeling and the biomarkers that distinguish different subtypes of severe asthma are unknown. We sought to characterize subjects with severe asthma with and without chronic persistent airflow obstruction with respect to airway wall remodeling (histopathologic and radiologic)...

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Published inJournal of allergy and clinical immunology Vol. 124; no. 1; pp. 45 - 51.e4
Main Authors Kaminska, Marta, Foley, Susan, Maghni, Karim, Storness-Bliss, Claudine, Coxson, Harvey, Ghezzo, Heberto, Lemière, Catherine, Olivenstein, Ronald, Ernst, Pierre, Hamid, Qutayba, Martin, James
Format Journal Article
LanguageEnglish
Published New York, NY Mosby, Inc 01.07.2009
Elsevier
Elsevier Limited
Subjects
ATS
SMA
WA
MPO
CT
MMP
ECP
MIP
ASM
MCP
RBM
Online AccessGet full text
ISSN0091-6749
1097-6825
1097-6825
DOI10.1016/j.jaci.2009.03.049

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Abstract The patterns of airway remodeling and the biomarkers that distinguish different subtypes of severe asthma are unknown. We sought to characterize subjects with severe asthma with and without chronic persistent airflow obstruction with respect to airway wall remodeling (histopathologic and radiologic) and specific sputum biomarkers. Subjects with severe asthma with chronic persistent (n = 16) or intermittent (n = 18) obstruction were studied. Endobronchial biopsy specimens were analyzed for airway smooth muscle area, epithelial detachment, basement membrane thickness, and submucosal fibrosis. Levels of eosinophil cationic protein, myeloperoxidase, matrix metalloproteinase 9, tissue inhibitor of matrix metalloproteinase 1 (ELISA), and 27 cytokines (multiplex assay) and differential cell counts were measured in induced sputum. Airway thickness was measured by means of high-resolution computed tomographic scanning. Chronic persistent obstruction was associated with earlier age of onset, longer disease duration, more inflammatory cells in the sputum, and greater smooth muscle area (15.65% ± 2.69% [n = 10] vs 8.96% ± 1.99% [n = 14], P = .0325). No differences between groups were found for any of the biomarker molecules measured in sputum individually. However, principal component analysis revealed that the dominant variables in the chronic persistent obstruction group were IL-12, IL-13, and IFN-γ, whereas IL-9, IL-17, monocyte chemotactic protein 1, and RANTES were dominant in the other group. Airway imaging revealed no differences between groups. Subjects with severe asthma with chronic persistent obstruction have increased airway smooth muscle with ongoing T H1 and T H2 inflammatory responses. Neither airway measurements on high-resolution computed tomographic scans nor sputum analysis seem able to identify such patients.
AbstractList The patterns of airway remodeling and the biomarkers that distinguish different subtypes of severe asthma are unknown. We sought to characterize subjects with severe asthma with and without chronic persistent airflow obstruction with respect to airway wall remodeling (histopathologic and radiologic) and specific sputum biomarkers. Subjects with severe asthma with chronic persistent (n = 16) or intermittent (n = 18) obstruction were studied. Endobronchial biopsy specimens were analyzed for airway smooth muscle area, epithelial detachment, basement membrane thickness, and submucosal fibrosis. Levels of eosinophil cationic protein, myeloperoxidase, matrix metalloproteinase 9, tissue inhibitor of matrix metalloproteinase 1 (ELISA), and 27 cytokines (multiplex assay) and differential cell counts were measured in induced sputum. Airway thickness was measured by means of high-resolution computed tomographic scanning. Chronic persistent obstruction was associated with earlier age of onset, longer disease duration, more inflammatory cells in the sputum, and greater smooth muscle area (15.65% ± 2.69% [n = 10] vs 8.96% ± 1.99% [n = 14], P = .0325). No differences between groups were found for any of the biomarker molecules measured in sputum individually. However, principal component analysis revealed that the dominant variables in the chronic persistent obstruction group were IL-12, IL-13, and IFN-γ, whereas IL-9, IL-17, monocyte chemotactic protein 1, and RANTES were dominant in the other group. Airway imaging revealed no differences between groups. Subjects with severe asthma with chronic persistent obstruction have increased airway smooth muscle with ongoing T H1 and T H2 inflammatory responses. Neither airway measurements on high-resolution computed tomographic scans nor sputum analysis seem able to identify such patients.
Background The patterns of airway remodeling and the biomarkers that distinguish different subtypes of severe asthma are unknown. Objectives We sought to characterize subjects with severe asthma with and without chronic persistent airflow obstruction with respect to airway wall remodeling (histopathologic and radiologic) and specific sputum biomarkers. Methods Subjects with severe asthma with chronic persistent (n = 16) or intermittent (n = 18) obstruction were studied. Endobronchial biopsy specimens were analyzed for airway smooth muscle area, epithelial detachment, basement membrane thickness, and submucosal fibrosis. Levels of eosinophil cationic protein, myeloperoxidase, matrix metalloproteinase 9, tissue inhibitor of matrix metalloproteinase 1 (ELISA), and 27 cytokines (multiplex assay) and differential cell counts were measured in induced sputum. Airway thickness was measured by means of high-resolution computed tomographic scanning. Results Chronic persistent obstruction was associated with earlier age of onset, longer disease duration, more inflammatory cells in the sputum, and greater smooth muscle area (15.65% ± 2.69% [n = 10] vs 8.96% ± 1.99% [n = 14], P = .0325). No differences between groups were found for any of the biomarker molecules measured in sputum individually. However, principal component analysis revealed that the dominant variables in the chronic persistent obstruction group were IL-12, IL-13, and IFN-γ, whereas IL-9, IL-17, monocyte chemotactic protein 1, and RANTES were dominant in the other group. Airway imaging revealed no differences between groups. Conclusion Subjects with severe asthma with chronic persistent obstruction have increased airway smooth muscle with ongoing TH 1 and TH 2 inflammatory responses. Neither airway measurements on high-resolution computed tomographic scans nor sputum analysis seem able to identify such patients.
The patterns of airway remodeling and the biomarkers that distinguish different subtypes of severe asthma are unknown. We sought to characterize subjects with severe asthma with and without chronic persistent airflow obstruction with respect to airway wall remodeling (histopathologic and radiologic) and specific sputum biomarkers. Subjects with severe asthma with chronic persistent (n = 16) or intermittent (n = 18) obstruction were studied. Endobronchial biopsy specimens were analyzed for airway smooth muscle area, epithelial detachment, basement membrane thickness, and submucosal fibrosis. Levels of eosinophil cationic protein, myeloperoxidase, matrix metalloproteinase 9, tissue inhibitor of matrix metalloproteinase 1 (ELISA), and 27 cytokines (multiplex assay) and differential cell counts were measured in induced sputum. Airway thickness was measured by means of high-resolution computed tomographic scanning. Chronic persistent obstruction was associated with earlier age of onset, longer disease duration, more inflammatory cells in the sputum, and greater smooth muscle area (15.65% +/- 2.69% [n = 10] vs 8.96% +/- 1.99% [n = 14], P = .0325). No differences between groups were found for any of the biomarker molecules measured in sputum individually. However, principal component analysis revealed that the dominant variables in the chronic persistent obstruction group were IL-12, IL-13, and IFN-gamma, whereas IL-9, IL-17, monocyte chemotactic protein 1, and RANTES were dominant in the other group. Airway imaging revealed no differences between groups. Subjects with severe asthma with chronic persistent obstruction have increased airway smooth muscle with ongoing T(H)1 and T(H)2 inflammatory responses. Neither airway measurements on high-resolution computed tomographic scans nor sputum analysis seem able to identify such patients.
The patterns of airway remodeling and the biomarkers that distinguish different subtypes of severe asthma are unknown.BACKGROUNDThe patterns of airway remodeling and the biomarkers that distinguish different subtypes of severe asthma are unknown.We sought to characterize subjects with severe asthma with and without chronic persistent airflow obstruction with respect to airway wall remodeling (histopathologic and radiologic) and specific sputum biomarkers.OBJECTIVESWe sought to characterize subjects with severe asthma with and without chronic persistent airflow obstruction with respect to airway wall remodeling (histopathologic and radiologic) and specific sputum biomarkers.Subjects with severe asthma with chronic persistent (n = 16) or intermittent (n = 18) obstruction were studied. Endobronchial biopsy specimens were analyzed for airway smooth muscle area, epithelial detachment, basement membrane thickness, and submucosal fibrosis. Levels of eosinophil cationic protein, myeloperoxidase, matrix metalloproteinase 9, tissue inhibitor of matrix metalloproteinase 1 (ELISA), and 27 cytokines (multiplex assay) and differential cell counts were measured in induced sputum. Airway thickness was measured by means of high-resolution computed tomographic scanning.METHODSSubjects with severe asthma with chronic persistent (n = 16) or intermittent (n = 18) obstruction were studied. Endobronchial biopsy specimens were analyzed for airway smooth muscle area, epithelial detachment, basement membrane thickness, and submucosal fibrosis. Levels of eosinophil cationic protein, myeloperoxidase, matrix metalloproteinase 9, tissue inhibitor of matrix metalloproteinase 1 (ELISA), and 27 cytokines (multiplex assay) and differential cell counts were measured in induced sputum. Airway thickness was measured by means of high-resolution computed tomographic scanning.Chronic persistent obstruction was associated with earlier age of onset, longer disease duration, more inflammatory cells in the sputum, and greater smooth muscle area (15.65% +/- 2.69% [n = 10] vs 8.96% +/- 1.99% [n = 14], P = .0325). No differences between groups were found for any of the biomarker molecules measured in sputum individually. However, principal component analysis revealed that the dominant variables in the chronic persistent obstruction group were IL-12, IL-13, and IFN-gamma, whereas IL-9, IL-17, monocyte chemotactic protein 1, and RANTES were dominant in the other group. Airway imaging revealed no differences between groups.RESULTSChronic persistent obstruction was associated with earlier age of onset, longer disease duration, more inflammatory cells in the sputum, and greater smooth muscle area (15.65% +/- 2.69% [n = 10] vs 8.96% +/- 1.99% [n = 14], P = .0325). No differences between groups were found for any of the biomarker molecules measured in sputum individually. However, principal component analysis revealed that the dominant variables in the chronic persistent obstruction group were IL-12, IL-13, and IFN-gamma, whereas IL-9, IL-17, monocyte chemotactic protein 1, and RANTES were dominant in the other group. Airway imaging revealed no differences between groups.Subjects with severe asthma with chronic persistent obstruction have increased airway smooth muscle with ongoing T(H)1 and T(H)2 inflammatory responses. Neither airway measurements on high-resolution computed tomographic scans nor sputum analysis seem able to identify such patients.CONCLUSIONSubjects with severe asthma with chronic persistent obstruction have increased airway smooth muscle with ongoing T(H)1 and T(H)2 inflammatory responses. Neither airway measurements on high-resolution computed tomographic scans nor sputum analysis seem able to identify such patients.
Background The patterns of airway remodeling and the biomarkers that distinguish different subtypes of severe asthma are unknown. Objectives We sought to characterize subjects with severe asthma with and without chronic persistent airflow obstruction with respect to airway wall remodeling (histopathologic and radiologic) and specific sputum biomarkers. Methods Subjects with severe asthma with chronic persistent (n = 16) or intermittent (n = 18) obstruction were studied. Endobronchial biopsy specimens were analyzed for airway smooth muscle area, epithelial detachment, basement membrane thickness, and submucosal fibrosis. Levels of eosinophil cationic protein, myeloperoxidase, matrix metalloproteinase 9, tissue inhibitor of matrix metalloproteinase 1 (ELISA), and 27 cytokines (multiplex assay) and differential cell counts were measured in induced sputum. Airway thickness was measured by means of high-resolution computed tomographic scanning. Results Chronic persistent obstruction was associated with earlier age of onset, longer disease duration, more inflammatory cells in the sputum, and greater smooth muscle area (15.65% ± 2.69% [n = 10] vs 8.96% ± 1.99% [n = 14],P= .0325). No differences between groups were found for any of the biomarker molecules measured in sputum individually. However, principal component analysis revealed that the dominant variables in the chronic persistent obstruction group were IL-12, IL-13, and IFN-γ, whereas IL-9, IL-17, monocyte chemotactic protein 1, and RANTES were dominant in the other group. Airway imaging revealed no differences between groups. Conclusion Subjects with severe asthma with chronic persistent obstruction have increased airway smooth muscle with ongoing TH1 and TH2 inflammatory responses. Neither airway measurements on high-resolution computed tomographic scans nor sputum analysis seem able to identify such patients.
Author Storness-Bliss, Claudine
Lemière, Catherine
Hamid, Qutayba
Kaminska, Marta
Ghezzo, Heberto
Olivenstein, Ronald
Ernst, Pierre
Coxson, Harvey
Maghni, Karim
Martin, James
Foley, Susan
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  surname: Kaminska
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  organization: Meakins-Christie Laboratories, Montreal, Quebec, Canada
– sequence: 2
  givenname: Susan
  surname: Foley
  fullname: Foley, Susan
  organization: Meakins-Christie Laboratories, Montreal, Quebec, Canada
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  givenname: Karim
  surname: Maghni
  fullname: Maghni, Karim
  organization: Centre de Recherche de l'Hopital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
– sequence: 4
  givenname: Claudine
  surname: Storness-Bliss
  fullname: Storness-Bliss, Claudine
  organization: Department of Radiology and the James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, Vancouver General Hospital, Vancouver, British Columbia, Canada
– sequence: 5
  givenname: Harvey
  surname: Coxson
  fullname: Coxson, Harvey
  organization: Department of Radiology and the James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, Vancouver General Hospital, Vancouver, British Columbia, Canada
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  givenname: Heberto
  surname: Ghezzo
  fullname: Ghezzo, Heberto
  organization: Meakins-Christie Laboratories, Montreal, Quebec, Canada
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  givenname: Catherine
  surname: Lemière
  fullname: Lemière, Catherine
  organization: Centre de Recherche de l'Hopital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
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  givenname: Ronald
  surname: Olivenstein
  fullname: Olivenstein, Ronald
  organization: Meakins-Christie Laboratories, Montreal, Quebec, Canada
– sequence: 9
  givenname: Pierre
  surname: Ernst
  fullname: Ernst, Pierre
  organization: Meakins-Christie Laboratories, Montreal, Quebec, Canada
– sequence: 10
  givenname: Qutayba
  surname: Hamid
  fullname: Hamid, Qutayba
  organization: Meakins-Christie Laboratories, Montreal, Quebec, Canada
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  fullname: Martin, James
  email: james.martin@mcgill.ca
  organization: Meakins-Christie Laboratories, Montreal, Quebec, Canada
BackLink http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21699090$$DView record in Pascal Francis
https://www.ncbi.nlm.nih.gov/pubmed/19481790$$D View this record in MEDLINE/PubMed
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CODEN JACIBY
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Issue 1
Keywords reticular basement membrane
ATS
FeNO
remodeling
SMA
airway smooth muscle
sputum
WA
MPO
high-resolution computed tomographic scan
CT
MMP
ECP
inflammation
MIP
biopsy
fibrosis
cytokines
HRCT
Severe asthma
ASM
MCP
RBM
TIMP
Fraction of exhaled nitric oxide
Matrix metalloproteinase
Computed tomography
Smooth muscle area
Myeloperoxidase
Wall area percentage
Monocyte chemotactic protein
High-resolution computed tomography
American Thoracic Society
Tissue inhibitor of matrix metalloproteinase
Eosinophil cationic protein
Macrophage inflammatory protein
High resolution
Smooth muscle
Remodeling
Respiratory system
Obstruction
Respiratory tract
Immunology
Human
Immunopathology
Radiodiagnosis
Cytokine
Inflammation
Basement membrane
Anatomic pathology
Chronic
Biopsy
Sputum
Fibrosis
Medical imagery
Computerized axial tomography
Language English
License https://www.elsevier.com/tdm/userlicense/1.0
CC BY 4.0
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Snippet The patterns of airway remodeling and the biomarkers that distinguish different subtypes of severe asthma are unknown. We sought to characterize subjects with...
Background The patterns of airway remodeling and the biomarkers that distinguish different subtypes of severe asthma are unknown. Objectives We sought to...
The patterns of airway remodeling and the biomarkers that distinguish different subtypes of severe asthma are unknown.BACKGROUNDThe patterns of airway...
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Enrichment Source
Publisher
StartPage 45
SubjectTerms Adult
Airway management
airway smooth muscle
Allergy and Immunology
Asthma
Asthma - pathology
Biological and medical sciences
biopsy
Chemokines
cytokines
Female
fibrosis
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Granulocytes - metabolism
high-resolution computed tomographic scan
Humans
Immunopathology
inflammation
Male
Matrix Metalloproteinase 9 - metabolism
Medical sciences
Methods
Middle Aged
Molecular weight
Muscle, Smooth - pathology
Muscular system
Proteins
Pulmonary Disease, Chronic Obstructive - pathology
remodeling
Respiratory System - diagnostic imaging
Respiratory System - pathology
reticular basement membrane
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Severe asthma
Smooth muscle
sputum
Sputum - immunology
Tissue Inhibitor of Metalloproteinase-1 - metabolism
Tomography, X-Ray Computed
Values
Vascular endothelial growth factor
Title Airway remodeling in subjects with severe asthma with or without chronic persistent airflow obstruction
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https://www.clinicalkey.es/playcontent/1-s2.0-S009167490900637X
https://dx.doi.org/10.1016/j.jaci.2009.03.049
https://www.ncbi.nlm.nih.gov/pubmed/19481790
https://www.proquest.com/docview/1504814321
https://www.proquest.com/docview/67427746
https://www.proquest.com/docview/876238897
Volume 124
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