Asthma diagnosis and treatmentSpecificity of basement membrane thickening in severe asthma
Section snippets
Patients
From 1996 to 2000, endobronchial biopsies (EBBs) were performed in 6 different clinical studies, approved by ethics committees, involving more than 300 patients. We selected the first 50 well characterized patients with mild-to-moderate untreated asthma, 50 current smokers with untreated COPD, and 50 patients with severe oral steroid–treated asthma. The diagnoses were made according to current guidelines.11, 12 The first 2 groups of patients were naive for anti-inflammatory treatment at the
Patient characteristics
Patients with mild and severe asthma and COPD presented markedly different phenotypes, as reported in Table I. Seventy percent of patients with mild asthma and 60% with severe asthma were atopic, and 3 of them were exsmokers (<5 pack-years, ceased for at least 1 year; Table I). Patients with COPD had a lower reversibility than patients with asthma (P = .0001). They were all current heavy smokers. Severe asthma and COPD groups presented with similar lung function at rest but significantly
Discussion
This study demonstrated that RBM thickness could differentiate patients with chronic airway disease when measured by 2 different validated methods. Remodeling in severe asthma was clearly different from remodeling in mild asthma and COPD, both of which differed from the situation observed in control subjects.
We chose the methods for RBM assessment by Wilson and Li8 and Sullivan et al9 because of their wide use and validation compared with methods as effective as TEM.8 Stereologic approaches
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Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.