Airway pathology in severe asthma is related to airflow obstruction but not symptom control

Autor(es):Mostrar menos -

Ferreira, D. S. ^[1] ; Carvalho-Pinto, R. M. ^[2] ; Gregorio, M. G. ^[2] ; Annoni, R. ^[1] ; Teles, A. M. ^[1] ; Buttignol, M. ^[1] ; Araujo-Paulino, B. B. ^[1] ; Katayama, E. H. ^[3] ; Oliveira, B. L. ^[3] ; Del Frari, H. S. ^[3] ; Cukier, A. ^[2] ; Dolhnikoff, M. ^[1] ; Stelmach, R. ^[2] ; Rabe, K. F. ^{[4, 5]} ; Mauad, T. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Dept Pathol, Sch Med, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Heart Inst InCor, Div Pulm, Sch Med, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Sch Med, Sao Paulo - Brazil

^[4] LungenClin Grosshansdorf, Grosshansdorf - Germany

^[5] German Ctr Lung Res DZL, Airway Res Ctr North, Heidelberg - Germany

• Tipo de documento: Artigo Científico
• Fonte: ALLERGY; v. 73, n. 3, p. 635-643, MAR 2018.
• Citações Web of Science: 4

Resumo

BackgroundPatients with asthma present structural and inflammatory alterations that are believed to play a role in disease severity. However, airway remodeling and inflammation have not been extensively investigated in relation to both symptom control and airflow obstruction in severe asthmatics. We aimed to investigate several inflammatory and structural pathological features in bronchial biopsies of severe asthmatics that could be related to symptom control and airflow obstruction after standardized treatment. MethodsFifty severe asthmatics received prednisone 40 mg/d for 2 weeks and maintenance therapy with budesonide/formoterol 400/12 g twice daily + budesonide/formoterol 200/6 g as needed for 12 weeks. Endobronchial biopsies were performed at the end of 12 weeks. We performed extensive immunopathological analyses of airway tissue inflammation and remodeling features in patients stratified by asthma symptom control and by airflow obstruction. ResultsAirway tissue inflammation and remodeling were not associated with symptom control. Asthmatics with persistent airflow obstruction had greater airway smooth muscle (Asm) area with decreased periostin and transforming growth factor beta-positive cells within Asm bundles, in addition to lower numbers of chymase-positive mast cells in the submucosa compared to patients with nonpersistent obstruction. ConclusionsSymptom control in severe asthmatics was not associated with airway tissue inflammation and remodeling, although persistent airflow obstruction in these patients was associated with bronchial inflammation and airway structural changes. (AU)

• Processo FAPESP: 13/03149-5 - American Thoracic Society 2013 International Conference
• Beneficiário: Diogenes Seraphim Ferreira
• Linha de fomento: Auxílio à Pesquisa - Reunião - Exterior
• Processo FAPESP: 05/58757-3 - Fatores relacionados a dificuldade do controle da asma: avaliação sistemática e caracterização dos fatores histológicos ralacionados a resposta ao tratamento
• Beneficiário: Rafael Stelmach
• Linha de fomento: Auxílio à Pesquisa - Regular