AIRWAY EPITHELIAL DAMAGE AND INFLAMMATION IN CHILDREN WITH RECURRENT BRONCHITIS

Inflammation and epithelial damage of the bronchial mucosa are frequen tly identified in children with bronchial diseases. Nevertheless, unti l now the quantitative assessment of the epithelial damage has never b een studied in relation to clinical or respiratory function or mucus a bnormalities. Bronchial biopsies and brushings were performed in 31 ch ildren with recurrent bronchitis and without atopia. The quantitative histologic data were compared with clinical results, the endoscopic ap pearance of the mucosa, ciliary beating frequency, mucus transport cap acity, leukocyte count, and protein concentration in mucus samples. Mo st of the biopsies (87%) collected in this group of children without r ecent acute infections showed extensive epithelial damage. A significa nt correlation was observed between the degree of shedding and edema ( p < 0.01). Bronchial epithelial edema was associated with a significan tly decreased (p < 0.01) mucus transport rate. Inflammation of the sub mucosa was significantly correlated with lymphocyte epithelial infiltr ation (p < 0.01), total mucus protein content (p < 0.01), and local ai rway inflammation estimated by bronchoscopy. These results demonstrate that children with recurrent bronchitis develop a severe bronchial in flammation associated with an increased mucus protein content and a re duction in the mucociliary function.