loading page

Functional Analysis of Airway Remodeling is Related with Fibrotic Mediators in Asthmatic Children
  • +11
  • Lucas Salles-Dias,
  • Ana Martins,
  • Maysa Brandao-Rangel,
  • Amanda Cristina-Rosa,
  • Rayssa Morais-Felix,
  • Simone Oliveira-Freitas,
  • Luis Oliveira,
  • Renilson Moraes-Ferreira,
  • Andre Bachi,
  • Silvia Nunez,
  • Elisa Coutinho,
  • Claudio Frison,
  • Asghar Abbasi,
  • Rodolfo Vieira
Lucas Salles-Dias
Universidade Brasil

Corresponding Author:[email protected]

Author Profile
Ana Martins
Universidade Brasil
Author Profile
Maysa Brandao-Rangel
Universidade Federal de Sao Paulo, UNIFESP - Universidade Federal de São Paulo
Author Profile
Amanda Cristina-Rosa
Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE)
Author Profile
Rayssa Morais-Felix
Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE)
Author Profile
Simone Oliveira-Freitas
Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE)
Author Profile
Luis Oliveira
UniEVANGÉLICA Centro Universitário de Anápolis
Author Profile
Renilson Moraes-Ferreira
Universidade Federal de Sao Paulo
Author Profile
Andre Bachi
Universidade Federal de Sao Paulo
Author Profile
Silvia Nunez
Universidade Brasil
Author Profile
Elisa Coutinho
Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE)
Author Profile
Claudio Frison
Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE)
Author Profile
Asghar Abbasi
UCLA Medical Center
Author Profile
Rodolfo Vieira
Universidade Brasil
Author Profile

Abstract

Background: Asthmatic children present variable degrees of airway inflammation, remodeling and resistance, which correlates with disease control and severity. Chronic inflammatory process of the airways triggers airway remodeling, which reflects the degree of airway resistance. Pro-inflammatory and pro-fibrotic mediators are centrally involved in this process. This study has investigated for the first time, whether the levels of pulmonary and systemic pro-inflammatory and pro-fibrotic mediators present correlation with the resistance of respiratory system and of proximal and distal airways. Methods: 24 asthmatic children (persistent mild and moderate) and 24 non-asthmatic children (both between 6-13 years old) were evaluated for anthropometric characteristics, lung function and mechanics, pulmonary and systemic immune response. Results: Asthmatic children showed an increased number of blood eosinophils (p<0.04), basophils (p<0.04), monocytes (p<0.002) and lymphocytes (p<0.03). In addition, asthmatic children showed an impaired lung function, as demonstrated by FEV1%pred. (p<0.0005) and FEV1/FVC (p<0.004), decreased total resistance of respiratory system (R5Hz; p<0.009), increased resistance of proximal airways (R20Hz; p<0.02), increased elastance (Z5Hz; p<0.02) and increased reactance (X5Hz; p<0.002). Moreover, the following inflammatory factors were significantly higher in asthmatic than non-asthmatic children: GM-CSF in the breath condensate (BC) (p<0.0001) and in the serum (p<0.0001); TGF-beta in the BC (p<0.0001) and in the serum (p<0.004); IL-5 in the BC (p<0.02) and in the serum (p<0.01); IL-4 in the serum (p<0.0002). Conclusions: Impulse oscillometry is a sensitive method to detect airway resistance in asthmatic children, reflecting airway remodeling, an event followed by increased levels of pro-inflammatory and pro-fibrotic mediators.