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Functional Analysis of Airway Remodeling is Related with Fibrotic Mediators in Asthmatic Children
  • +11
  • Lucas Salles-Dias,
  • Ana Carolina Martins,
  • Maysa Brandao-Rangel,
  • Amanda Cristina-Rosa,
  • Rayssa Morais-Felix,
  • Simone Oliveira-Freitas,
  • Luis Vicente de Oliveira,
  • Renilson Moraes-Ferreira,
  • Andre Bachi,
  • Elisa Coutinho,
  • Silvia Nunez,
  • Claudio Frison,
  • Asghar Abbasi,
  • Rodolfo Vieira
Lucas Salles-Dias
Universidade Brasil

Corresponding Author:[email protected]

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Ana Carolina Martins
Universidade Brasil
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Maysa Brandao-Rangel
UNIFESP - Universidade Federal de São Paulo, Universidade Federal de São Paulo
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Amanda Cristina-Rosa
Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE)
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Rayssa Morais-Felix
Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE)
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Simone Oliveira-Freitas
Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE)
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Luis Vicente de Oliveira
UniEVANGELICA Centro Universitario de Anapolis
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Renilson Moraes-Ferreira
Universidade Federal de São Paulo
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Andre Bachi
Universidade de Santo Amaro
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Elisa Coutinho
Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE)
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Silvia Nunez
Universidade Brasil
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Claudio Frison
Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE)
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Asghar Abbasi
University of California Los Angeles
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Rodolfo Vieira
Universidade Brasil
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Abstract

Background: Asthmatic children present variable degrees of airway inflammation, remodeling and resistance, which correlates with disease control and severity. Chronic inflammatory process of the airways triggers airway remodeling, which reflects the degree of airway resistance. Pro-inflammatory and pro-fibrotic mediators are centrally involved in this process. This study has investigated for the first time, whether the levels of pulmonary and systemic pro-inflammatory and pro-fibrotic mediators present correlation with the resistance of respiratory system and of proximal and distal airways. Methods: 24 asthmatic children (persistent mild and moderate) and 24 non-asthmatic children (both between 6-13 years old) were evaluated for anthropometric characteristics, lung function and mechanics, pulmonary and systemic immune response. Results: Asthmatic children showed an increased number of blood eosinophils (p<0.04), basophils (p<0.04), monocytes (p<0.002) and lymphocytes (p<0.03). In addition, asthmatic children showed an impaired lung function, as demonstrated by FEV1%pred. (p<0.0005) and FEV1/FVC (p<0.004), decreased total resistance of respiratory system (R5Hz; p<0.009), increased resistance of proximal airways (R20Hz; p<0.02), increased elastance (Z5Hz; p<0.02) and increased reactance (X5Hz; p<0.002). Moreover, the following inflammatory factors were significantly higher in asthmatic than non-asthmatic children: GM-CSF in the breath condensate (BC) (p<0.0001) and in the serum (p<0.0001); TGF-beta in the BC (p<0.0001) and in the serum (p<0.004); IL-5 in the BC (p<0.02) and in the serum (p<0.01); IL-4 in the serum (p<0.0002). Conclusions: Impulse oscillometry is a sensitive method to detect airway resistance in asthmatic children, reflecting airway remodeling, an event followed by increased levels of pro-inflammatory and pro-fibrotic mediators.
12 Jun 2020Submitted to Pediatric Pulmonology
12 Jun 2020Submission Checks Completed
12 Jun 2020Assigned to Editor
14 Jun 2020Reviewer(s) Assigned
08 Jul 2020Review(s) Completed, Editorial Evaluation Pending
10 Jul 2020Editorial Decision: Revise Major