Service de Pneumologie et d'Allergologie Pédiatriques, AP-HP, Hôpital Necker-Enfants Malades, Paris, France.
Université Paris Descartes, Paris, France.
Eur Respir J. 2016 Nov;48(5):1320-1328. doi: 10.1183/13993003.00947-2016. Epub 2016 Oct 6.
The role of mast cells in the pathogenesis of childhood asthma is poorly understood. We aimed to estimate the implication of airway mucosal mast cells in severe asthma and their relationship with clinical, functional, inflammatory and remodelling parameters.Bronchial biopsies were performed in 36 children (5-18 years) with severe asthma: 24 had frequent severe exacerbations and/or daily symptoms in the previous year (symptomatic group), and 12 had few symptoms and a persistent obstructive pattern (paucisymptomatic group). Nine children without asthma were included as control subjects. We assessed mast cells in the submucosa and airway smooth muscle using c-kit antibodies and in the entire biopsy area using Giemsa.The number of submucosal mast cells was higher in the symptomatic group than in the paucisymptomatic group (p=0.02). The number of submucosal mast cells correlated with the number of severe exacerbations (p=0.02, r=0.37). There were positive correlations between the number of submucosal mast cells (p<0.01, r=0.44), airway smooth muscle mast cells (p=0.02, r= 0.40), mast cells stained by Giemsa (p<0.01, r=0.44) and submucosal eosinophils.Mast cells are associated with severe exacerbations and submucosal eosinophilic inflammation in children with severe asthma.
肥大细胞在儿童哮喘发病机制中的作用尚未完全阐明。我们旨在评估气道黏膜肥大细胞在重症哮喘中的作用及其与临床、功能、炎症和重塑参数的关系。
对 36 例重症哮喘患儿（5-18 岁）进行支气管活检：24 例患儿在过去一年中频繁发生严重恶化和/或每日有症状（症状组），12 例患儿症状较少且持续存在阻塞模式（症状少组）。9 例无哮喘的儿童作为对照。我们使用 c-kit 抗体评估黏膜下和气道平滑肌中的肥大细胞，使用吉姆萨染色评估整个活检区域中的肥大细胞。
症状组患儿的黏膜下肥大细胞数量高于症状少组（p=0.02）。黏膜下肥大细胞数量与严重恶化次数呈正相关（p=0.02，r=0.37）。黏膜下肥大细胞（p<0.01，r=0.44）、气道平滑肌肥大细胞（p=0.02，r=0.40）、吉姆萨染色肥大细胞（p<0.01，r=0.44）与黏膜下嗜酸性粒细胞之间存在正相关。
肥大细胞与儿童重症哮喘的严重恶化和黏膜下嗜酸性粒细胞炎症有关。
