Pediatr Allergy Respir Dis.
1998 Sep;8(2):190-197.
Bronchial Structural Changes in Childhood Asthma
- Affiliations
-
- 1 Department of Pediatrics, College of Medicine, Soonchunhyang University, Seoul, Korea.
Abstract
- PURPOSE
While asthma has been considered to be a completely reversible obstructive airway disease, many asthmatics have evidences of residual airway obstruction. Therefore, with the recent attention to the cells participating in inflammation, the definition of asthma was modified based on pathophysiologic observations including the inflammation of the airways. Airway inflammation, demonstrable in most of the asthmatics, is already present in the airways of patients with very mild asthma and is increased with the severity of the disease. It also has been associated with the development of airway hyperresponsiveness. However, the mechanisms by which the airway inflammation leads to airway hyperresponsiveness may result from various factors including the evidences of airway remodeling. These findings indicate that asthma is a disease with important airway remodeling which may leads to permanent tissue destruction. High-resolution computed tomography (HRCT) provides a high degree of anatomic details and can indirectly confirm airways remodeling in asthmatics, such as bronchial thickening, mucoid impaction, bronchial dilatation and bronchiectasis.
METHODS
Twenty children with asymptomatic chronic moderate to severe asthma, who have visited pediatric allergy clinic in Soonchunhyang University, were performed HRCT to find out the airway changes in comparison with the asthma severity and the duration of asthma history.
RESULTS
High resolution computed tomography revealed various findings, such as bronchial wall thickening, mosaic perfusion, atelectasis and bronchiectasis. The results indicate no positive correlation with the asthma severity and the duration of asthma history.
CONCLUSION
Therefore, early intervention for diagnosis and treatment of asthma is very important to prevent the permenant chronic airway obstruction and airway remodeling in childhood asthma.
