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Eur Respir J. 2016 Aug;48(2):393-402. doi: 10.1183/13993003.01525-2015. Epub 2016 May 26.

Lung function decline in asthma patients with elevated bronchial CD8, CD4 and CD3 cells.

Author information

1
Dept of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands I.den_Otter@lumc.nl.
2
Dept of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.
3
Dept of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.
4
Dept of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands Dept of Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Abstract

Which inflammatory markers in the bronchial mucosa of asthma patients are associated with decline of lung function during 14 years of prospective follow-up?To address this question, 19 mild-to-moderate, atopic asthmatic patients underwent spirometry and bronchoscopy at baseline and after 14 years of follow-up (t=14). Baseline bronchial biopsies were analysed for reticular layer thickness, eosinophil cationic protein (EG2), mast cell tryptase (AA1), CD3, CD4 and CD8. Follow-up biopsies were stained for EG2, AA1, neutrophil elastase, CD3, CD4, CD8, CD20, granzyme B, CD68, DC-SIGN, Ki67 and mucins.Decline in forced expiratory volume in 1 s (FEV1) % predicted was highest in patients with high CD8 (p=0.01, both pre- and post-bronchodilator) or high CD4 counts at baseline (p=0.04 pre-bronchodilator, p=0.03 post-bronchodilator). Patients with high CD8, CD3 or granzyme B counts at t=14 also exhibited faster decline in FEV1 (p=0.00 CD8 pre-bronchodilator, p=0.04 CD8 post-bronchodilator, p=0.01 granzyme B pre-bronchodilator, and p<0.01 CD3 pre-bronchodilator).Long-term lung function decline in asthma is associated with elevation of bronchial CD8 and CD4 at baseline, and CD8, CD3 and granzyme B at follow-up. This suggests that high-risk groups can be identified on the basis of inflammatory phenotypes.

PMID:
27230446
DOI:
10.1183/13993003.01525-2015
[Indexed for MEDLINE]
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