Immunohistology and remodeling in fatal pediatric and adolescent asthma

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http://hdl.handle.net/10138/190722

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Malmström , K , Lohi , J , Sajantila , A , Jahnsen , F L , Kajosaari , M , Sarna , S & Makela , M J 2017 , ' Immunohistology and remodeling in fatal pediatric and adolescent asthma ' , Respiratory Research , vol. 18 , 94 . https://doi.org/10.1186/s12931-017-0575-0

Title: Immunohistology and remodeling in fatal pediatric and adolescent asthma
Author: Malmström, Kristiina; Lohi, Jouko; Sajantila, Antti; Jahnsen, Frode L.; Kajosaari, Merja; Sarna, Seppo; Makela, Mika J.
Contributor: University of Helsinki, Department of Dermatology, Allergology and Venereology
University of Helsinki, Department of Pathology
University of Helsinki, Medicum
University of Helsinki, Children's Hospital
University of Helsinki, Seppo Sarna / Principal Investigator
University of Helsinki, Clinicum
Date: 2017-05-16
Language: eng
Number of pages: 9
Belongs to series: Respiratory Research
ISSN: 1465-9921
URI: http://hdl.handle.net/10138/190722
Abstract: Background: Thickening of reticular basement membrane, increased airway smooth muscle mass and eosinophilic inflammation are found in adult fatal asthma. At the present study the histopathology of fatal paediatric and adolescent asthma is evaluated. Methods: Post-mortem lung autopsies from 12 fatal asthma cases and 8 non-asthmatic control subjects were examined. Thickness of reticular basement membrane (RBM) and percentage of airway smooth muscle (ASM%) mass area were measured and inflammatory cells were counted. Patient records were reviewed for clinical history. Results: The age range of the cases was from 0.9 to 19.5 years, eight were males and five had received inhaled corticosteroids. Thickened RBM was detected in majority of the cases without any correlation to treatment delay, age at onset of symptoms or diagnosis. In the large airways ASM was clearly increased in one third of the cases whereas the median ASM% did not differ from that in healthy controls (14.0% vs. 14.0%). In small airways no increase of ASM was found, instead mucous plugs were seen in fatal asthma. The number of eosinophils, plasmacytoid dendritic cells, macrophages, and B-cells were significantly increased in fatal asthma cases compared with controls and the two latter correlated with the length of the fatal exacerbation. Conclusions: The findings highlight the strong presence of eosinophils and mucous plugs even in small airways in children and adolescents with fatal asthma. Thickened RBM was obvious in majority of the patients. Contrary to our hypothesis, increased ASM% was detected in only one third of the patients.
Subject: Airway smooth muscle
Eosinophils
Fatal pediatric and adolescent asthma
Histopathology
Reticular basement membrane
AIRWAY SMOOTH-MUSCLE
EOSINOPHILIC INFLAMMATION
PRESCHOOL WHEEZERS
DIFFICULT ASTHMA
CHILDHOOD ASTHMA
BRONCHIAL-ASTHMA
MODERATE ASTHMA
DENDRITIC CELLS
CHILDREN
HYPERPLASIA
3121 General medicine, internal medicine and other clinical medicine
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