Bronchial ciliogenesis and oral steroid treatment in patients with asthma

doi:10.1016/0007-0971(88)90040-X

British Journal of Diseases of the Chest

Volume 82, 1988, Pages 175-178

https://doi.org/10.1016/0007-0971(88)90040-X Get rights and content

Abstract

The effect of steroids on the ciliogenesis of bronchial epithelium has not previously been studied in asthmatics. Bronchial biopsies were taken during bronchoscopy from five asthmatics before and after oral steroid treatment, and studied by transmission electron microscopy. Two untreated healthy subjects served as controls. After treatment ciliogenesis was abundant in all patients.

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Cited by (12)

Glucocorticoid actions on airway epithelial responses in immunity: Functional outcomes and molecular targets
2007, Journal of Allergy and Clinical Immunology
Citation Excerpt :
An increase in the number of ciliated cells, with restoration of the ciliated/goblet cell ratio, was documented by electron microscopy after a 3-month treatment with ICSs in newly diagnosed patients with asthma,39 and epithelial cells in sputum decreased after glucocorticoid treatment.40 In a small study, glucocorticoid treatment had a positive effect on ciliogenesis.41 However, only a partial reduction of epithelial damage was seen after 10 years of daily ICS treatment in patients with severe asthma.42
Research on the biology of airway epithelium in the last decades has progressively uncovered the many roles of this cell type during the immune response. Far from the early view of the epithelial layer simply as a passive barrier, the airway epithelium is now considered a central player in mucosal immunity, providing innate mechanisms of first-line host defense as well as facilitating adaptive immune responses. Alterations of the epithelial phenotype are primarily involved in the pathogenesis of allergic airways disease, particularly in severe asthma. Appreciation of the epithelium as target of glucocorticoid therapy has also grown, because of studies defining the pathways and mediators affected by glucocorticoids, and studies illustrating the relevance of the control of the response from epithelium in the overall efficacy of topical and systemic therapy with glucocorticoids. Studies of the mechanism of action of glucocorticoids within the biology of the immune response of the epithelium have uncovered mechanisms of gene regulation involving both transcriptional and posttranscriptional events. The view of epithelium as therapeutic target therefore has plenty of room to evolve, as new knowledge on the role of epithelium in immunity is established and novel pathways mediating glucocorticoid regulation are elucidated.
Airway inflammation as an assessment of chronic nonproductive cough
2001, Chest
Citation Excerpt :
Epithelial damage along with inflammatory cell infiltration have been observed in patients with chronic cough. This is supported by studies789 showing that steroids assist in healing the damaged epithelial cells by suppressing the infiltration of inflammatory cells, and that they also participate in regenerating the destroyed cilia, which results in a reduction of coughing. Therefore, the pathogenesis of chronic cough can be summarized as the damage of epithelial cells due to airway inflammation.
The possibility that a bronchial inflammatory process could be involved with a chronic nonproductive cough without other potential causes such as postnasal drip syndrome, bronchial asthma, gastroesophageal reflux, chronic bronchitis, bronchiectasis, or the use of angiotensin-converting enzyme inhibitors has not been clearly described. We investigated the possibility that a chronic nonproductive cough without other potential causes is associated with airway inflammation, and if this is so, what the relationship might be between this inflammation and the possible etiology of the cough.
Twenty-five adults with chronic nonproductive cough as an isolated symptom over a 3-week period, and 5 healthy control subjects were studied.
Clinical assessments, cough scores, methacholine challenges, allergy skin prick tests, and bronchoscopies for bronchial biopsies were performed. In the bronchial biopsies, the patients were divided into the following two subgroups: 21 patients who were infiltrated with eosinophils vs the healthy control group (median, 12.0 vs 0.0 cells/mm², respectively; p < 0.01); and 4 patients who were infiltrated with lymphocytes vs the healthy control group (median, 84.5 vs 22.0 cells/mm², respectively; p < 0.01). With the methacholine challenge test, 5 of the 21 eosinophil-infiltrated patients received diagnoses of cough-variant asthma, and the other 16 patients received diagnoses of eosinophilic bronchitis. In the lymphocyte-infiltrated group, all four patients received diagnoses of lymphocytic bronchitis.
These results suggest that a chronic nonproductive cough as an isolated symptom is associated with airway inflammation due to eosinophil and lymphocyte infiltration. The causes of the chronic nonproductive cough were eosinophilic bronchitis, cough-variant asthma, and lymphocytic bronchitis.
The effect of inflammation on mucociliary clearance asthma: An overview
2000, Chest
Citation Excerpt :
It is also a characteristic pathologic featureof asthmatic tissue obtained from autopsy,17 bronchialbiopsy50 and BAL.51 In this regard, ciliatedcells obtained in bronchial biopsy52 and in BAL53 correlate with the degree of bronchialresponsiveness, and ciliary destruction is more evident with persistentdisease, although it can be reversed with steroidtreatment.54 Structural changes, such as ciliary epithelial lesions, with cells thatoften appear swollen, as well as intercellular space edema have beendescribed in the airway epithelium of asthmatic patients
Mucociliary clearance (MCC) is one of the most importantnonspecific defense mechanisms of the respiratory tract, and itsimpairment is a well-documented feature of chronic respiratorydiseases, including asthma. In vitro and in vivo data suggest that severalinflammatory mediators influence the mucociliary apparatus. Epithelialdamage and functional abnormalities have been described in bronchialasthma, along with changes in mucus-secreting cells and the chemicaland rheological properties of airway fluid. Although the mechanisms of MCC impairment in asthma are not clearly understood, data in therecent literature suggest that airway inflammation plays a majorrole. In this article, we review studies on MCC alterations in light of up-to-date findings on pathogenetic mechanisms inasthma.
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Transcriptomic and Lipidomic Profiles in Nasal Polyps of Glucocorticoid Responders and Non-Responders: Before and After Treatment
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Airway epithelial cell cilia and obstructive lung disease
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Short communicationBronchial ciliogenesis and oral steroid treatment in patients with asthma

Abstract

Scanning electron microscopic studies of bronchial mucosa before and during treatment with beclomethasone dipropionate inhalations

Scand J Resp Dis Suppl

Fiberoptic bronchoscopy including bronchial biopsies in asthmatics after long-term high dose budesonide aerosol

Prog Resp Res

Damage of the airway epithelium and bronchial reactivity in patients with asthma

Am Rev Resp Dis

Ultrastructure of the bronchial epithelium in three children with asthma

Pediat Pulmonol

Reconstruction of centriole formation and ciliogenesis in mammalian lungs

J Cell Sci

Short communication
Bronchial ciliogenesis and oral steroid treatment in patients with asthma