View Abstract

A3804 - Goblet-Cellular Component of Epithelium and Inflammatory Pattern of Bronchi in Asthmatics with Cold Airway Hyperresponsiveness
Author Block: J. M. Perelman1, A. B. Pirogov2, A. G. Prikhodko1, S. V. Zinov'ev3, V. P. Kolosov2; 1Laboratory of Functional Research of Respiratory System, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Blagoveschensk, Russian Federation, 2Laboratory of Prophylaxis of Nonspecific Lung Diseases, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Blagoveschensk, Russian Federation, 3Central Research Laboratory, Amur State Medical Academy, Blagoveschensk, Russian Federation.
RATIONALE. Inflammatory pattern and mucociliary insufficiency in asthmatics with cold airway hyperresponsiveness (CAHR) can be the causes of an uncontrolled course of the disease. We aimed to assess an airway inflammatory pattern and destructive-cytolitic activity of goblet cells in asthmatics with CAHR. METHODS. 24 patients with mild persistent asthma (mean age 39.3±1.6 years) were assessed upon asthma control, lung function (FEV1), airway response (ΔFEV1) to 3-minute isocapnic hyperventilation with cold (-20ºС) air (IHCA). In the induced sputum (IS) the cell percentage, the degree of cellular elements destruction and cytolysis intensiveness were assessed. There were distinguished 5 classes of destruction (from 0 - normal structure to 4 - full destruction of nucleus and cytoplasm disintegration). The total index of cells destruction (ICD) was calculated: ICD = (n0+n1+n2+n3+n4)/100; where n0⋯n4 is the number of cells of the corresponding class of destruction. The index of cells cytolysis intensiveness (ICC) was calculated as the ratio of most damaged cells to the contents of the remaining damaged cells: ICD = n4/(n0+n1+n2+n3+n4). RESULTS. By the airway response to IHCA the patients were divided into groups: 1st group included 14 patients with CAHR, the 2nd group - 10 patients with it (ΔFEV1 was -19.9±1.6% vs. -2.3±1.1%, respectively, р=0.000001). The patients of the 1st group had lower FEV1 (79.9±4.6% vs. 97.1±7.1%, р=0.047), and asthma control (14.2±1.3 vs. 18.3±1.4 points ACT, р=0.043). In IS of the patients of the 1st group in comparison with the 2nd one there was found a higher percentage of neutrophils (51.2±3.4 and 41.1±3.3%, р=0.044); there was marked but nonsignificant tendency to the increase of eosinophils number and the decrease of the number of goblet cells. ICD for goblet cells was 0.45±0.04 vs. 0.37±0.04 (р=0.20), ICC was 0.21±0.02 vs. 0.15±0.02, respectively (р=0.04). Goblet cells with the total disintegration of the nucleus and cytoplasm (IV class) dominated in the IS of the 1st group in comparison with the 2nd group: 21.3±2.3 vs. 14.6±2.4%, respectively (р=0.14), against the lower number of cells with the normal structure (0 class): 55.4±2.4 vs. 63.0±2.7%, respectively (р=0.047). We found a close correlation between ΔFEV1 and the number of neutrophils of IS (r=-0.89, р=0.004) and ICC for goblet cells (r=-0.65, р=0.041) in the 1st group. CONCLUSION. The increase of neutrophilic component of the inflammatory pattern and destructive and cytolitic activity of goblet cells in asthmatics with CAHR can lead to the escalation of inflammation and progression of mucociliary insufficiency.