Airway Remodeling In Asthmatic Patients And Its Relationship With Inflammatory Mediators And Cytokines In Sputum And Serum

Bronchial asthma is a cbrpnic inflammatory disorder of the airways. Chronic inflammation causes pathologic changes in the airways of asthmatic patients , markedly remodeling bronchial structure. Purpose: Airway remodeling, evaluated as the subepitbelial layer thickness, was compared in asthmatic patients with that of healthy subjects, and was related to clinical parameters, inflammatory mediators ~nd cytokines in sputum and serum. Subjects and methods: Fiberoptic bronchoscope with bronchial mucosa biopsy was performed on 20 stable asthmatics and 10 normal subjects. The subepithelial layer thickness (BM) in biopsy sample was measured. Levels of eosinophil catiOnic protein (ECP), mterleukin ? (IL-5 ) , tumor necrolsis factor-alpha ( TNF- a ) , both in sputum and serum, were measured. For patients with asthma, total number of attacks and duration of disease were recorded, FEVi and provocation concentration at 20%fall of FEV1 after histamine challenge (PC20) were measured. Unpaired t-test was used to measure the differene in the thickness of basement membrane of asthmatic patients and normal subjects. Relationships between ECP, IL-5, TNT- a, FEVi, PC20 and BM were estimated by the Spearman rank correlation. Results: The mean BM were significantly higher in asthmatic patients 3 than in normal subjects(10.14 ?2.56 i~ m Vs 4.43 ?1.15 1?in P<0.005). In ast~抜matics patients, BM was negatively correlated with FEV1 and PC20 (correlation cQefficient rs= -0.518; P<0.05 and rs=- 0.532, P<0.05, respectively) , and positively correlated with total number of attackd ~ind duration of disease ( rs=0.465, P<0.05 and rs=0.654, P<0.005, respectively). ECP and IL-S level in sputum were positively correlated with BM ( rs=0.569, p