The clinical utility of reticular basement membrane thickness measurements in asthmatic children

Abstract

This study confirms the difference in RBM thickness between children with and without asthma and between asthma severities in a routine clinical care setting. However, quantifying the RBM thickness appeared to have no added clinical diagnostic value for asthma in children.

The relationship between inflammation and remodeling in childhood asthma: A systematic review

“…Sixteen studies recorded the presence of previous asthma attacks. Twenty‐nine studies recorded current asthma medications …”

“…Fourteen studies had a control group defined as non‐asthmatic/wheezing children (two also included adults); in 11 studies there was no control group; in six studies the control group was defined as upper airways symptoms; in six studies the control group was defined as lower respiratory problems but non‐asthma; and one study compared children that in the future developed asthma (positive vs negative athma predictive index [API]) (Table ).…”

“…Airway inflammation was determined in 20 studies . Significant airway eosinophilia was reported in seven studies (in BAL alone, in biopsy alone, and in both); while eosinophilic cationic protein (ECP) in BAL was elevated in three studies, but not in one .…”

“…(1) Studies exclusively in school‐age asthmatics compared with controls (defined by the presence of upper airway symptoms) which have shown significantly more BAL eosinophils, EPC and tryptase, subepithelial eosinophils, mucosal eosinophils, intraepithelial neutrophils, and submucosal and epitelhial IL‐17RA‐positive cells . There were also studies that reported significantly increased RBM thickness, hypertrophy and hyperplasia of ASM, but not epithelial sheeding, and decreased expression of TGFβ‐RII, in asthmatic. (2) Studies exclusively in school‐age asthmatics compared with controls (defined by the presence of lower respiratory symptoms, but not asthma) have reported more mucosal eosinophils, and significantly increased RBM thickness, in asthmatic.…”

“…We looked for correlations between airway inflammation and remodeling with other biomarkers, including radiological imaging. FeNO was measured in eleven studies, but only had a direct correlation with RBM thickness in three ( r = 0.474, r = 0.61, r = 0.45). There was no association between FeNO and airway inflammation, presumably related to the high levels of treatment prescribed for patients undergoing clinically indicated bronchoscopy .…”