Bronchoalveolar lavage findings in infant wheeze
Bronchoalveolar lavage findings in infant wheeze
Persistent infant wheezing is associated with atopy and this would suggest that airway remodelling has occurred in a manner similar to atopic asthma. Matrix metalloproteinase (MMP)-9 and Tissue Inhibitor of MMP (TIMP)-1 have been implicated in airway remodelling. The aim of this study was to consider the role of atopy infant wheeze and its relationship to the persistence of symptoms by the investigation of bronchoalveolar (BAL) and nasal lavage (NAL) in infancy.
In an international multicentre study, 52 severe infant wheezers underwent clinical investigation by bronchoscopy with BAL and concomitant NAL. Differential cytology, ECP, IL-8, sICAM-1, MMP-9 and TIMP-1 concentrations were measured in the lavages. A subgroup of the study was followed up by questionnaire at a mean age of four years to look for persistence of symptoms and other allergic diseases.
A high proportion of wheezers had bacterial infection of BAL and lavage neutrophillia of both upper and lower respiratory tract as well as MMP-9 TIMP-1 molar ratio imbalance. Previously, viral but not bacterial infection has been associated with wheeze. Atopic wheezers did not show either an eosinophillia or MMP-TIMP imbalance, but correlations in BAL suggested that atopic wheezers had inflammation linked to epithelial cell shedding. In infants with Allergic Rhinitis (AR), eosinophils were raised in NAL and also in BAL with signs of epithelial shedding once more. This would suggest that airway remodelling was occurring in these children. NAL was sufficiently different from BAL not to provide a useful surrogate for this invasive procedure. Persistent wheeze was associated with clinical AR, BAL TIMP-1 and serum sICAM-1 concentrations in infancy.
This study suggests that persistent infant wheezers have airway remodelling, which involves airway fibrosis via TIMP-1, occurs early in the disease, and is linked to nasal symptoms in a manner similar to adult allergic asthma.
University of Southampton
Erlewyn-Lajeunesse, Michel David Siva
2b215d0b-d3ef-4e69-b1db-be12a93ec1dc
2004
Erlewyn-Lajeunesse, Michel David Siva
2b215d0b-d3ef-4e69-b1db-be12a93ec1dc
Erlewyn-Lajeunesse, Michel David Siva
(2004)
Bronchoalveolar lavage findings in infant wheeze.
University of Southampton, Doctoral Thesis.
Record type:
Thesis
(Doctoral)
Abstract
Persistent infant wheezing is associated with atopy and this would suggest that airway remodelling has occurred in a manner similar to atopic asthma. Matrix metalloproteinase (MMP)-9 and Tissue Inhibitor of MMP (TIMP)-1 have been implicated in airway remodelling. The aim of this study was to consider the role of atopy infant wheeze and its relationship to the persistence of symptoms by the investigation of bronchoalveolar (BAL) and nasal lavage (NAL) in infancy.
In an international multicentre study, 52 severe infant wheezers underwent clinical investigation by bronchoscopy with BAL and concomitant NAL. Differential cytology, ECP, IL-8, sICAM-1, MMP-9 and TIMP-1 concentrations were measured in the lavages. A subgroup of the study was followed up by questionnaire at a mean age of four years to look for persistence of symptoms and other allergic diseases.
A high proportion of wheezers had bacterial infection of BAL and lavage neutrophillia of both upper and lower respiratory tract as well as MMP-9 TIMP-1 molar ratio imbalance. Previously, viral but not bacterial infection has been associated with wheeze. Atopic wheezers did not show either an eosinophillia or MMP-TIMP imbalance, but correlations in BAL suggested that atopic wheezers had inflammation linked to epithelial cell shedding. In infants with Allergic Rhinitis (AR), eosinophils were raised in NAL and also in BAL with signs of epithelial shedding once more. This would suggest that airway remodelling was occurring in these children. NAL was sufficiently different from BAL not to provide a useful surrogate for this invasive procedure. Persistent wheeze was associated with clinical AR, BAL TIMP-1 and serum sICAM-1 concentrations in infancy.
This study suggests that persistent infant wheezers have airway remodelling, which involves airway fibrosis via TIMP-1, occurs early in the disease, and is linked to nasal symptoms in a manner similar to adult allergic asthma.
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Published date: 2004
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Local EPrints ID: 465471
URI: http://eprints.soton.ac.uk/id/eprint/465471
PURE UUID: ea9fddb7-7eb6-4cad-8112-07a4045db5ad
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Date deposited: 05 Jul 2022 01:15
Last modified: 16 Mar 2024 20:12
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Author:
Michel David Siva Erlewyn-Lajeunesse
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