Thorax 2001;56:25-29 ( January )

Ultrastructural examination of bronchial biopsy specimens from children with moderate asthma

H Çokura, N Akçakaya, Seçkin, Y Camcolu, N Sarmurat, F Aksoy

Sükran Ciftligi Sok, Onur Ap. No. 35/15, Bakirköy, Istanbul, Turkey

Correspondence to: Dr H Çokura hcokugras{at}turkpediatri.org.tr

Received 15 February 2000; Returned to authors 20 June 2000; Revised version received 8 August 2000; Accepted for publication 20 September 2000

BACKGROUNDFew studies have evaluated the asthmatic airway in childhood. The aim of this study was to assess the histopathological changes occurring in the bronchi of children with moderate asthma using light and electron microscopy.
METHODSBronchial biopsy specimens from 10 children with moderate asthma (seven boys) of mean (SD) age 9.3 (3.8) years (range 5-14) were examined by light and electron microscopy. Patients had not had a respiratory infection for at least one month and they had not been treated with steroids or sodium cromoglycate for four weeks before the study. Bronchoscopy was performed under general anaesthesia using a Karl Storz rigid paediatric bronchoscope. Biopsy materials were stained with uracyl acetate and lead citrate and evaluated under a Zeiss-10 electron microscope and light microscope.
RESULTSThe most important finding was thickening and hyalinisation of the basement membrane in nine patients. The ciliated epithelial cells showed loss of cilia in some cases. Overactive fibroblasts were consistently found. Six patients had degranulating mast cells and lymphocyte infiltration in the submucosa. Eosinophils were seen in only one biopsy sample.
CONCLUSIONChildren with moderate asthma develop bronchial inflammation similar to the reaction observed in adults. However, in our study the inflammation was rich in lymphocytes rather than eosinophils.


Keywords: paediatric asthma; lymphocytes; bronchoscopy; electron microscopy

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© 2001 by Thorax
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