Rationale: Airway remodeling and inflammation are characteristic features of adult asthma that are still poorly investigated in childhood asthma. Objectives: To examine epithelial and vascular changes as well as the inflammatory response in airways of children with asthma. Methods: We analyzed bronchial biopsies obtained from 44 children undergoing bronchoscopy for appropriate clinical indications other than asthma: 17 with mild/moderate asthma (aged 2-15 yr), 12 with atopy without asthma (1-11 yr), and 15 control children without atopy or asthma (1-14 yr). By histochemistry and immunohistochemistry, we quantified epithelial loss, basement membrane thickness, number of vessels, and inflammatory cells in subepithelium. Results: Epithelial loss and basement membrane thickness were increased in children with asthma compared with control subjects (p ϭ 0.005 and p ϭ 0.0002, respectively) and atopic children (p ϭ 0.002 and p ϭ 0.005, respectively). The number of vessels and eosinophils was increased not only in asthmatic children (p ϭ 0.03 and p ϭ 0.0002, respectively) but also in atopic children without asthma (p ϭ 0.03 and p ϭ 0.008, respectively) compared with control subjects. When we stratified the analysis according to age, we observed that children with asthma younger than 6 yr had increased epithelial loss, basement membrane thickening, and eosinophilia compared with control subjects of the same age. Conclusions: Epithelial damage and basement membrane thickening, which are pathologic features characteristic of adult asthma, are present even in childhood asthma. Other changes, such as airway eosinophilia and angiogenesis, were also observed in atopic children without asthma. These observations suggest that pathologic changes occur early in the natural history of asthma and emphasize the concept that some of these lesions may characterize atopy even in the absence of asthmatic symptoms.

Over the last 30 years there has been considerable interest in the use of functional electrical stimulation (FES) to restore movement to the limbs of paralyzed patients. Spinal cord injury causes a rapid loss in both muscle mass and contractile force. The atrophy is especially severe when the injury involves lower motoneurons because many months after spinal cord injury, atrophy is complicated by fibrosis and fat substitution. In this study we describe the effects of long-term lower motoneuron denervation of human muscle and present the structural results of muscle trained using FES. By means of an antibody for embryonic myosin, we demonstrate that many regenerative events continue to spontaneously occur in human long-term denervated and degenerated muscle (DDM). In addition, using electron microscopy, we describe i) the overall structure of fibers and myofibrils in long-term denervated and degenerated muscle, including the effects of FES, and ii) the structure and localization of calcium release units, or triads; the structures reputed to activate muscle contraction during excitation-contraction coupling (ECC). Both apparatus undergo disarrangement and re-organization following long-term denervation and FES, respectively. The poor excitability of human long-term DDM fibers, which extends to the first periods of FES training, may be explained in terms of the spatial disorder of the ECC apparatus. Its disorganization and re-organization following long-term denervation and FES, respectively, may play a key role in the parallel disarrangement and re-organization of the myofibrils that characterize denervation and FES training. The present structural studies demonstrate that the protocol used during FES training is effective in reverting long-term denervation atrophy and dystrophy. The mean fiber diameter in FES biopsies is 42.2 +/- 14.8 SD (p < 0.0001 vs DDM 14.9 +/- 6.0 SD); the mean percentile of myofiber area of the biopsy is 94.3 +/- 5.7 SD (p < 0.0001 vs DDM 25.7 +/- 23.7 SD); the mean percentile fat area is 2.1 +/- 2.4 SD (p < 0.001 vs DDM 12.8 +/- 12.1 SD); and the mean percentile connective tissue area is 3.6 +/- 4.6 SD (p < 0.001 vs DDM 61.6 +/- 20.1 SD). In DDM biopsies more than 50% of myofibers have diameter smaller than 10 microm, while the FES-trained subjects have more that 50% of myofibers larger than 30 microm. The recovery of muscle mass seems to be the result of both a size increase of the surviving fibers and the regeneration of new myofibers.

This study shows that the airway pathology typical of asthma is present in nonatopic wheezing children just as in atopic wheezing children. These results suggest that, when multitrigger wheezing responsive to bronchodilators is present, it is associated with pathologic features of asthma even in nonatopic children.

) is a bioactive lipid known to control cell growth that was recently shown to act as a trophic factor for skeletal muscle, reducing the progress of denervation atrophy. The aim of this work was to investigate whether S1P is involved in skeletal muscle fiber recovery (regeneration) after myotoxic injury induced by bupivacaine. The postnatal ability of skeletal muscle to grow and regenerate is dependent on resident stem cells called satellite cells. Immunofluorescence analysis demonstrated that S1P-specific receptors S1P1 and S1P3 are expressed by quiescent satellite cells. Soleus muscles undergoing regeneration following injury induced by intramuscular injection of bupivacaine exhibited enhanced expression of S1P1 receptor, while S1P3 expression progressively decreased to adult levels. S1P 2 receptor was absent in quiescent cells but was transiently expressed in the early regenerating phases only. Administration of S1P (50 M) at the moment of myotoxic injury caused a significant increase of the mean crosssectional area of regenerating fibers in both rat and mouse. In separate experiments designed to test the trophic effects of S1P, neutralization of endogenous circulating S1P by intraperitoneal administration of anti-S1P antibody attenuated fiber growth. Use of selective modulators of S1P receptors indicated that S1P1 receptor negatively and S1P3 receptor positively modulate the early phases of regeneration, whereas S1P2 receptor appears to be less important. The present results show that S1P signaling participates in the regenerative processes of skeletal muscle. sphingosine 1-phosphate receptors; satellite cells SPHINGOSINE 1-PHOSPHATE (S1P) is a bioactive lysolipid known to regulate many critical biological processes, such as cell proliferation, survival, migration, and angiogenesis (15, 42). The extracellular action of S1P is exerted by binding to five specific cell surface G protein-coupled S1P receptors, S1P 1 -S1P 5 (4). S1P 1 , S1P 2 , and S1P 3 are expressed in all mammalian tissues, whereas S1P 4 and S1P 5 are more tissue specific. Genetic deletion of S1P 1 receptor is fatal to embryos (19), and the simultaneous deletion of both S1P 2 and S1P 3 receptors produces perinatal lethality, while S1P 2 -deficient mice are apparently healthy (16). The distinctive combination of individual S1P receptors, differentially coupled to heterotrimeric G proteins, determines in a given cell the specific biological response produced by S1P (42). S1P receptor-dependent signaling has been demonstrated in skeletal muscle cells. The mRNAs of S1P 1 -S1P 3 receptors are detectable in the myogenic C2C12 cell line derived from mouse satellite cells, with S1P 1 expression being the highest (25, 36). The relative expression of S1P receptors changes during myogenic differentiation of C2C12 cells, particularly that of S1P 2 , which progressively diminishes during differentiation and becomes almost absent by the time myotubes are formed (22). Consistently in rat adult skeletal muscle RT-PCR and Western blot data demonstrated the exp...

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