loading page

Bronchial smooth muscle remodelling impacts the exacerbation frequency of severe preschool wheezers
  • +10
  • Fabien Beaufils,
  • Pauline Esteves,
  • Raphael Enaud,
  • Renaud Prevel,
  • Pauline Henrot,
  • Marilyne Campagnac,
  • Elise Maurat,
  • marine michelet,
  • Frederic Lavrand,
  • Hugues Bégueret,
  • Thomas Trian,
  • Michael Fayon,
  • Patrick Berger
Fabien Beaufils
Universite de Bordeaux

Corresponding Author:[email protected]

Author Profile
Pauline Esteves
Universite de Bordeaux
Author Profile
Raphael Enaud
Universite de Bordeaux
Author Profile
Renaud Prevel
Universite de Bordeaux
Author Profile
Pauline Henrot
Universite de Bordeaux
Author Profile
Marilyne Campagnac
Universite de Bordeaux
Author Profile
Elise Maurat
Universite de Bordeaux
Author Profile
marine michelet
Centre Hospitalier Universitaire de Toulouse
Author Profile
Frederic Lavrand
Centre Hospitalier Universitaire de Bordeaux
Author Profile
Hugues Bégueret
Centre Hospitalier Universitaire de Bordeaux
Author Profile
Thomas Trian
Universite de Bordeaux
Author Profile
Michael Fayon
Universite de Bordeaux
Author Profile
Patrick Berger
Universite de Bordeaux
Author Profile

Abstract

INTRODUCTION: Exacerbations in preschool wheezers increase the risk of impaired lung function and asthma persistence at school age. Bronchial remodelling-based latent classes identify severe preschool wheezers at increased risk of frequent exacerbations (>3) but failed to distinguish those without exacerbation from those with low exacerbations rate (1-2 exacerbations) in the year following bronchoscopy. We thus aimed to identify further independent factors associated with no, low or high exacerbation rates. METHODS: In this post-hoc analysis, 80 severe preschool wheezers from the “P’tit Asthme” and “RESPIRE” studies were divided into 3 groups: No-Ex (0 exacerbation in the year following the bronchoscopy, n=20), Low-Ex (1-2 exacerbations, n=27) and High-Ex (≥3 exacerbations, n=33). Associations between variables and groups were assessed using multinomial logistic regressions. RESULTS: Atopic dermatitis, age at the first wheezing episode, Haemophilus and Streptococcus genera in the bronchoalveolar lavage fluid (BALF), bronchial smooth muscle (BSM) area, reticular basement membrane (RBM) thickness and RBM-BSM distance were all significantly different between No-Ex and/or Low-Ex and/or High-Ex. However, only atopic dermatitis, age at first episode of wheezing, Haemophilus genus in the BALF, RBM-BSM distance and BSM area were significantly and independently associated with exacerbation frequency. Among them, the BSM area was the sole parameter independently associated with each group. CONCLUSION: While atopic dermatitis, age at the first episode of wheezing, Haemophilus in BALF, RBM-BSM distance and BSM area appeared to be relevant independent parameters associated with exacerbation susceptibility in severe preschool wheezers, only the increased BSM area discriminated between each of the three-exacerbation frequency-based groups.