Ventilation Inhomogeneity and Bronchial Basement Membrane Changes in Chronic Neutrophilic Airway Inflammation

dc.contributor.authorKoucký, Václav
dc.contributor.authorUhlík, Jiří
dc.contributor.authorHoňková, Lenka
dc.contributor.authorKoucký, Miroslav
dc.contributor.authorDoušová, Tereza
dc.contributor.authorPohunek, Petr
dc.date.accessioned2020-03-27T16:12:08Z
dc.date.available2020-03-27T16:12:08Z
dc.date.issued2020-03-27
dc.description.abstractBackground: Bronchial epithelial reticular basement membrane (RBM) thickening occurs in diseases with both eosinophilic (allergic bronchial asthma [BA]) and neutrophilic (cystic fibrosis [CF] and primary ciliary dyskinesia [PCD]) chronic airway inflammation; however, the lung function and airway remodeling relation remains unclear. The aim of this study was to test whether ventilation inhomogeneity is related to RBM thickening. Methods: Multiple breath washout test, endobronchial biopsy, and BAL were performed in 24 children with CF, 11 with PCD, 15 with BA, and in 19 control subjects. Lung clearance index at 2.5% (1/40th) of starting nitrogen concentration (LCI2.5), RBM thickness, and lavage fluid cytology were quantified; their mutual associations were studied by using Spearman rank correlations (r). Results: In asthma, ventilation inhomogeneity (mean ± SD) was mild (LCI2.5, 9.3 ± 1.4 vs 7.9 ± 0.9 in control subjects; P = .0391), and the RBM thickened (5.26 ± 0.98 μm vs 3.12 ± 0.62 μm in control subjects; P < .0001). No relation between RBM thickness and ventilation inhomogeneity or lavage cytology was found. In CF and PCD, RBM thickness was similar to that in asthma (4.54 ± 0.66 μm and 5.27 ± 1.11 μm, respectively), but ventilation inhomogeneity was significantly higher (LCI2.5, 12.5 ± 2.4 and 11.8 ± 2.5). Both in CF and PCD, RBM thickness correlated with LCI2.5 (r = 0.594, P = .015; r = 0.821, P = .023). In PCD only, RBM thickness was also related to the number of neutrophils in lavage fluid (r = 0.821; P = .023). Conclusions: Lung function impairment in relation to RBM thickness was milder in BA than in CF and PCD. In asthma, ventilation inhomogeneity did not correlate with RBM thickness, whereas it did in CF and PCD. This outcome suggests a different structure-function relation in these diseases.cs
dc.identifier.doi10.1016/j.chest.2019.10.023
dc.identifier.issn123692
dc.identifier.urihttps://dspace.tul.cz/handle/15240/154660
dc.identifier.urihttps://www.sciencedirect.com/science/article/abs/pii/S0012369219341881?via%3Dihub
dc.language.isocscs
dc.publisherElsevier Inc
dc.relation.ispartofChest 2020
dc.subjectairway remodelingcs
dc.subjectbronchial asthmacs
dc.subjectcystic fibrosiscs
dc.subjectmultiple breath washout testcs
dc.subjectprimary ciliary dyskinesiacs
dc.subjectreticular basement membrane thickeningcs
dc.titleVentilation Inhomogeneity and Bronchial Basement Membrane Changes in Chronic Neutrophilic Airway Inflammationcs
dc.typeConference Paper
local.identifier.publikace7513
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