Original ArticleBronchoalveolar lavage cellular composition in acute asthma and acute bronchiolitis☆
Section snippets
Study Population
The study subjects included 18 patients with asthma, 20 patients with respiratory syncytial virus bronchiolitis, and 14 control subjects who underwent FB with BAL. Fifty-six subjects were originally included in the study. However, 4 cases had to be excluded from the analysis because of positive viral cultures in 2 patients with asthma (adenovirus and influenza A, respectively), an insufficient lavage return in 1 patient with RSV bronchiolitis, and a positive bacterial culture (Streptococcus
Results
Comparisons of the 3 groups showed that children with RSV bronchiolitis were significantly younger than children in the other 2 groups and that those with asthma had significantly higher serum IgE levels and blood eosinophil counts (Table I).Empty Cell Asthma group (n =18) Bronchiolitis group (n = 20) Control group (n = 14) Age (y)* 5.1 (2.0-10.2) 0.7†‡ (0.4-2.0) 6.0 (3.4-10.6) Sex (M:F) 12:6 11:9 10:4 Serum IgE (IU/mL)* 259†§ (110-1568) 16 (6-58) 119 (40-298) Blood eosinophils (/mm3)* 465†§
Discussion
Our results show that neutrophils were the predominant cells in BAL fluid from children with RSV bronchiolitis and that the most consistent cellular finding in children with asthma was an increase in eosinophil number. It seems likely that neutrophils contribute significantly to inflammation within the airways in RSV bronchiolitis, whereas eosinophils play a crucial role in the airway inflammation in asthma. Our results indicate that there is a differential elevation of inflammatory cells in
References (35)
- et al.
Soluble intercellular adhesion molecule 1 (ICAM-1) antigen in sera of bronchial asthmatics
Chest
(1996) - et al.
Eosinophil degranulation in the respiratory tract during naturally acquired respiratory syncytial virus infection
J Pediatr
(1992) - et al.
Cellular immunity is activated and a TH-2 response is associated with early wheezing in infants after bronchiolitis
J Pediatr
(1997) Acute bronchiolitis– a perennial problem [letter]
Lancet
(1996)- et al.
Correlation of bronchial eosinophil and mast cell activation with bronchial hyperresponsiveness in children with asthma
J Allergy Clin Immunol
(1992) - et al.
Relationships among numbers of bronchoalveolar lavage cells expressing messenger ribonucleic acid for cytokines, asthma symptoms, and airway methacholine responsiveness in atopic asthma
J Allergy Clin Immunol
(1993) - et al.
Identification by immunofluorescence of eosinophil granule major basic protein in lung tissues of patients with bronchial asthma
Lancet
(1982) - et al.
Dexamethasone in bronchiolitis: a randomised controlled trial
Lancet
(1996) - et al.
Bronchiolitis
Pediatr Rev
(1993) - et al.
Wheezing, asthma, and pulmonary dysfunction 10 years after infection with respiratory syncytial virus in infancy
Br Med J
(1982)
Asthma and immunoglobulin E antibodies after respiratory syncytial virus bronchiolitis: a prospective cohort study with matched controls
Pediatrics
Immunological responses to respiratory syncytial virus infection in infancy
Arch Dis Child
Eosinophil activation in asthma
N Engl J Med
Expression of IL-4 and IL-5 mRNA and protein product by CD4+ and CD8+ T cells, eosinophils, and mast cells in bronchial biopsies obtained from atopic and nonatopic (intrinsic) asthmatics
J Immunol
Bronchoalveolar lavage as a research tool
Thorax
Bronchoalveolar lavage [annotation]
Arch Dis Child
Asthma: a follow up statement from an international paediatric asthma consensus group
Arch Dis Child
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Reprint requests: Young Yull Koh, MD, Department of Pediatrics, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.