Abstract
Remodelling of the bronchial wall was thought to be a typical characteristic for asthma and the result of chronic inflammation. Structural changes were documented in bronchial mucosa of preschool children treated for asthma. We have very limited knowledge about the onset of these changes in small children. The course of wheezing disorders in young age cannot be reliably predicted, so it is difficult to identify the most probable candidates for developing asthma.
The aim of our study is to identify abnormalitites in the bronchial wall in children with high-risk of developing asthma. We examined endobronchial biopsies from 23 children under 4 years of age undergoing flexible bronchoscopy for clinical reasons others than recurrent wheezing. Twelve children fulfiled the criteria of Asthma Predictive Index, eleven children were in the control group. Thickness of the basement membrane was significantly higher in the high risk group than in the controls (on the average 4.14 μm vs. 3.53 μm respectively). On the other side, there seems to be no significant difference in the presence of neutrophil leucocytes and myofibroblasts between the two groups. This may correlate with the fact that all the patients were suffering from chronic or repeated respiratory problems for which they were indicated to bronchoscopy. However we suggest that first signs of remodelling like thickening of the basement membrane can be already present in children with high-risk of developing asthma in very early age. This may help us to improve therapeutic interventions in these children to prevent further development of irreversible morphological changes in later age. Supported by IGA MH CR No. NT 11444 and NT 11459.
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