MIRIAM CARDOSO NEVES ELLER

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  • article 3 Citação(ões) na Scopus
    Bronchial eosinophils, neutrophils, and CD8+T cells influence asthma control and lung function in schoolchildren and adolescents with severe treatment-resistant asthma
    (2022) ELLER, Miriam Cardoso Neves; VERGANI, Karina Pierantozzi; SARAIVA-ROMANHOLO, Beatriz Mangueira; COSTA, Natalia de Souza Xavier; BRITO, Jose Mara de; ANTONANGELO, Leila; FARIA, Caroline Silverio; RODRIGUES, Joaquim Carlos; MAUAD, Thais
    BackgroundStudies in adult severe treatment-resistant asthma (STRA) have demonstrated heterogeneous pathophysiology. Studies in the pediatric age group are still scarce, and few include bronchial tissue analysis. ObjectiveWe investigated 6-18-year-old patients diagnosed with STRA in Sao Paulo, Brazil, by characterizing the different lung compartments and their correlations with asthma control and lung function. MethodsInflammatory profiles of 13 patients with a confirmed diagnosis of STRA were analyzed using blood, induced sputum, bronchoalveolar lavage, viral and bacterial screens and endobronchial biopsy. Inflammatory cells, cytokines, and basement membrane thickening were tested for correlations with the asthma control test (ACT) and spirometry and plethysmography parameters. ResultsEndobronchial biopsy specimens from 11 patients were viable for analysis. All biopsies showed eosinophilic infiltration. Submucosal (SM) eosinophils and neutrophils were correlated with worse lung function (pre-BD FEV1), and SM neutrophils were correlated with fixed obstruction (post-BD FEV1). Intraepithelial (IE) neutrophils were positively correlated with lung function (pre-BD sGaw). CD8 + T cells had the highest density in the IE and SM layers and were positively correlated with ACT and negatively correlated with the cytokines IL1 beta, IL2, IL5, IL7, IL10, IL12, IL17, GCSF, MCP-1, INF-delta, and TNF alpha in sputum supernatant. The ASM chymase + mast cell density correlated positively with quality-of-life score (pAQLQ) and ACT. ConclusionEosinophils and SM neutrophils correlated with worse lung function, while IE neutrophils correlated with better lung function. Most importantly, CD8 + T cells were abundant in bronchial biopsies of STRA patients and showed protective associations, as did chymase + mast cells.