Nonatopic Children with Multitrigger Wheezing Have Airway Pathology Comparable to Atopic Asthma

• DOI: 10.1164/rccm.200712-1818oc
• Publication Date: 2008-05-30T01:36:25Z
• Authors: Graziella Turato; Angelo Barbato; Simonetta Baraldo; Maria Elena Zanin; Erica Bazzan; Kim Lokar-Oliani; Fiorella Calabrese; Cristina Panizzolo; Deborah Snijders; Piero Maestrelli; Renzo Zuin; Leonardo M. Fabbri; Marina Saetta
• Keywords: Wheeze; Atopy

Rationale: Epidemiologic studies have shown that, in atopic children, wheezing is more likely to persist into adulthood, eventually becoming asthma, whereas it appears resolve by adolescence nonatopic children.Objectives: To investigate whether among children with multitrigger wheeze responsive bronchodilators the airway pathology would be different wheezers, who are often considered nonasthmatic, compared frequently diagnosed as having asthma.Methods: Bronchial biopsies were obtained from 55 undergoing bronchoscopy for appropriate clinical indications: 18 (median age, 5 yr; range, 2–10 yr), 20 (medan 2–15 and 17 control no atopy or 4; 2–14 yr). By histochemistry immunohistochemistry, we quantified epithelial loss, basement membrane thickness, angiogenesis, inflammatory cells, IL-4+, IL-5+ cells subepithelium.Measurements Main Results: Unexpectedly, all pathologic features examined similar children. Compared subjects, both had increased loss (P = 0.03 P 0.002, respectively), thickened (both < 0.0001), number of vessels 0.003 0.03, respectively) eosinophils 0.0001 respectively). Moreover, they cytokine expression, which was highly significant IL-4 0.002 0.0001, marginal IL-5 0.02 0.08, respectively).Conclusions: This study shows that typical asthma present just These results suggest when present, associated even