Lung function, airway remodeling, and inflammation in infants: outcome at 8 years

Malmström, Kristiina; Malmberg, L. Pekka; O'Reilly, Ruth; Lindahl, Harry; Kajosaari, Merja; Saarinen, Kimmo; Saglani, Sejal; Jahnsen, Frode L.; Bush, Andrew; Haahtela, Tari; Sarna, Seppo; Pelkonen, Antti; Mäkelä, Mika J.

doi:10.1016/j.anai.2014.09.019

Cited by 32 publications

(37 citation statements)

References 34 publications

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“…Thus, other studies are needed to assess the relation between ASM area and future exacerbations in preschoolers with severe recurrent wheeze. The absence of a relationship between past RBM thickness and persistent asthma supports previous findings, and confirms the absence of an association between RBM thickness and symptom duration previously described in children with severe asthma …”

Section: Discussionsupporting

confidence: 90%

“…It is unlikely that ASM had mechanically improved lung function by increasing bronchodilation because we found no correlation between ASM area and FEV1 reversibility. However, this result supports the lower airway hyperreactivity observed at school age in children who had a higher ASM area in infancy . Conversely, airways vascularity in the preschool years negatively correlated with lung function at school age.…”

Section: Discussionsupporting

confidence: 74%

“…The potential role of eosinophils in persistent asthma is supported by functional data showing that eosinophils from symptomatic asthmatics are more likely activated than those from asthmatic symptom‐free children or children without asthma . Such an association between eosinophils in the preschool years and exacerbations at school age has not been observed in other cohorts . However, in contrast to other cohorts, our patients were all under a prolonged course of high‐dose ICS at the time of biopsy.…”

Section: Discussionmentioning

confidence: 53%

“…Markers of remodelling and inflammation have been described in preschool children with severe wheeze as in older children or adults with asthma . The influence of these pathological features on clinical and functional outcomes at school age has rarely been evaluated . Reticular basement membrane (RBM) thickness and mucosal inflammatory cell counts appear to be unrelated to clinical or functional outcomes at school age .…”

Section: Introductionmentioning

confidence: 99%

“…The influence of these pathological features on clinical and functional outcomes at school age has rarely been evaluated . Reticular basement membrane (RBM) thickness and mucosal inflammatory cell counts appear to be unrelated to clinical or functional outcomes at school age . Studies concerning airway smooth muscle (ASM) have provided conflicting results, and it remains unclear whether a greater ASM area in preschool wheezers is a risk factor for persistent asthma at school age .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Remodelling and inflammation in preschoolers with severe recurrent wheeze and asthma outcome at school age

Lezmi

Deschildre

Taam³

et al. 2018

Clin Experimental Allergy

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Remodelling and inflammation in preschoolers with severe recurrent wheeze and asthma outcome at school age

Lezmi

Deschildre

Taam³

et al. 2018

Clin Experimental Allergy

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Airway remodeling in asthma: what really matters

2017

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Airway remodeling is generally quite broadly defined as any change in composition, distribution, thickness, mass or volume and/or number of structural components observed in the airway wall of patients relative to healthy individuals. However, two types of airway remodeling should be distinguished more clearly: (1) physiological airway remodeling, which encompasses structural changes that occur regularly during normal lung development and growth leading to a normal mature airway wall or as an acute and transient response to injury and/or inflammation, which ultimately results in restoration of a normal airway structures; and (2) pathological airway remodeling, which comprises those structural alterations that occur as a result of either disturbed lung development or as a response to chronic injury and/or inflammation leading to persistently altered airway wall structures and function. This review will address a few major aspects: (1) what are reliable quantitative approaches to assess airway remodeling? (2) Are there any indications supporting the notion that airway remodeling can occur as a primary event, i.e., before any inflammatory process was initiated? (3) What is known about airway remodeling being a secondary event to inflammation? And (4), what can we learn from the different animal models ranging from invertebrate to primate models in the study of airway remodeling? Future studies are required addressing particularly pheno-/endotype-specific aspects of airway remodeling using both endotype-specific animal models and “endotyped” human asthmatics. Hopefully, novel in vivo imaging techniques will be further advanced to allow monitoring development, growth and inflammation of the airways already at a very early stage in life.

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