Bronchoscopic evaluation of severe asthma. Persistent inflammation associated with high dose glucocorticoids.

摘要: The role of inflammation in the pathogenesis severe asthma chronically treated with high doses glucocorticoids is poorly understood. Despite this, treatment has been aimed at advancing anti-inflammatory and immunomodulator therapy. This study was designed to evaluate both presence type airway patients asthma. A prospective bronchoscopic evaluated 14 severe, high-dose oral glucocorticoid dependent asthmatics. Bronchoalveolar lavage fluid analyzed for cytology inflammatory mediators. Endobronchial transbronchial biopsies were performed selected morphometric evaluation macrophage/monocytes, neutrophils, eosinophils lymphocytes. These results compared endo- biopsy studies normal controls moderate concentration bronchoalveolar highest asthmatics not on glucocorticoids, very little difference between (significant among groups, p = 0.007). In contrast, demonstrated a twofold higher neutrophils than either mild-moderate asthmatics, or (p 0.032 < 0.05 controls). Similar obtained endobronchial specimens, which consistently showed significantly numbers control groups. eicosanoid mediators, thromboxane leukotriene B4, also group (differences 0.019 0.023, respectively). findings suggest that remains symptomatic despite dose may be due severity disease, treatment, other as yet undefined factors.