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Influence of bronchial epithelium destruction on clinical manifestations of asthma in patients with cold airway hyperresponsiveness

[Internal diseases]
Alexey Pirogov; Sergey Zinov’ev; Tatiana Maltseva; Anna Prikhodko; Victor Kolosov; Yuliy Perelman;

We studied the features of destruction of bronchial epithelium in asthma patients with cold airway hyperresponsiveness (CAHR) and its influence on clinical-functional manifestations of the disease. 67 asthma patients with CAHR (1st group included 33 patients with mild asthma, 2nd group had 24 patients with severe asthma) had clinical-functional examination; induced sputum (IS) was collected, the cellular composition was defined, the degree of bronchial epithelium destruction was found according to 5 classes of destruction and calculation of total index of cell destruction (ICD). The group of control included 40 asthma patients without CAHR. IS of the patients of 1st and 2nd groups had a higher concentration of neutrophils than in the control. The patients of the 2nd group had more damaged epithelial cells of I and IV classes of destruction, and higher ICD; there was found a close correlation between the number of points by ACT questionnaire and the number of epithelial cells in IS, between II and IV classes of destruction and FEV1, as well as between III class of destruction and FEV1 increase to β2-agonist inhalation. We suggested the intensification of bronchial epithelium destruction in asthma patients
with CAHR has a negative influence on clinical-functional manifestations of the disease; it is associated with worsening of asthma course and manifests the escalation of bronchial remodeling.

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Keywords: asthma, cold airway hyperresponsiveness, inflammation, disease control, bronchial epithelium destruction


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