Airway Inflammation in Mild Intermittent and in Persistent Asthma

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Abstract
The severity of asthma can be graded from mild intermittent to severe persistent. Airway inflamma- tion is a feature of persistent asthma. We compared several markers of inflammation in mucosal biop- sies and bronchoalveolar lavage fluid (BAL fluid) from 12 healthy control subjects, 24 patients with intermittent asthma, and 18 patients with mild-to-moderate persistent asthma. Epithelial shedding, eosinophil (EG2-positive cells), and activated T-cell (UCHL1) counts in biopsies, and ECP levels in BAL fluids were significantly increased in patients with intermittent asthma by comparison with control subjects and this increase was significantly greater for patients with persistent asthma. Alveolar mac- rophage activation (percentage of hypodense cells) and the thickness of the basement membrane were significantly increased in asthmatic subjects as compared with controls but there was no differ- ence between the two asthmatic groups. Hyaluronic acid levels in BAL fluids were significantly in- creased in patients with persistent asthma by comparison with control subjects and patients with in- termittent asthma. Mast cell numbers (toluidine blue) in biopsies and histamine or levels in BAL fluids were similar in the three groups. This study shows that airways inflammation is present in patients with intermittent asthma but to a lesser extent than in patients with persistent asthma. Vignola AM, Chanez P, Campbell AM, Souques F, Lebel B, Enander I, Bousquet J. Airway inflammation in mild intermittent and in persistent asthma. AM J RESPIR CRIT CARE MED 1998;157:403-409.