Mast-Cell Infiltration of Airway Smooth Muscle in Asthma

doi:10.1056/NEJMoa012705

Volume 346:1699-1705		May 30, 2002		Number 22

Mast-Cell Infiltration of Airway Smooth Muscle in Asthma

Christopher E. Brightling, M.B., B.S., Peter Bradding, D.M., Fiona A. Symon, Ph.D., Stephen T. Holgate, M.D., D.Sc., Andrew J. Wardlaw, Ph.D., and Ian D. Pavord, D.M.

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by Black, J.

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ABSTRACT

Background Asthma and eosinophilic bronchitis are characterizedby similar inflammatory infiltrates in the submucosa of thelower airway. However, eosinophilic bronchitis differs fromasthma in that there is no variable airflow obstruction or airwayhyperresponsiveness in the former condition. We tested the hypothesisthat there were differences between the two conditions in themicrolocalization of mast cells within the airway smooth muscle.

Methods Immunohistochemical analysis of bronchial-biopsy specimenswas completed in 17 subjects with asthma, 13 subjects with eosinophilicbronchitis, and 11 normal controls recruited from two centers.

Results Both groups with disease had a similar degree of submucosaleosinophilia and thickening of the basement membrane and laminareticularis. By contrast, the number of tryptase-positive mastcells in the bundles of airway smooth muscle from subjects withasthma (median, 5.1 mast cells per square millimeter of smoothmuscle [range, 0 to 33.3]) was substantially higher than thatin subjects with eosinophilic bronchitis (median, 0 mast cellsper square millimeter; range, 0 to 4.8) and that in normal controls(median, 0 mast cells per square millimeter [range, 0 to 6.4];P<0.001 for the comparison among the three groups). T cellsand eosinophils were not usually seen in the airway smooth musclein any of the groups.

Conclusions The infiltration of airway smooth muscle by mastcells is associated with the disordered airway function foundin asthma.

Source Information

From the Division of Respiratory Medicine, Institute for Lung Health, Leicester–Warwick Medical School and University Hospitals of Leicester, Leicester (C.E.B., P.B., F.A.S., A.J.W., I.D.P.); and the University of Southampton and Southampton General Hospital, Southampton (S.T.H.) — both in the United Kingdom.

Address reprint requests to Dr. Pavord at the Department of Respiratory Medicine, University Hospitals of Leicester, Groby Rd., Leicester LE3 9QP, United Kingdom.

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N Engl J Med 2002; 347:1040-1041, Sep 26, 2002. Correspondence

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