Pulmonary periarterial inflammation in fatal asthma
Article first published online: 22 MAY 2009
© 2009 Blackwell Publishing Ltd
Clinical & Experimental Allergy
Volume 39, Issue 10, pages 1499–1507, October 2009
How to Cite
Shiang, C., Mauad, T., Senhorini, A., De Araújo, B. B., Ferreira, D. S., Da Silva, L. F. F., Dolhnikoff, M., Tsokos, M., Rabe, K. F. and Pabst, R. (2009), Pulmonary periarterial inflammation in fatal asthma. Clinical & Experimental Allergy, 39: 1499–1507. doi: 10.1111/j.1365-2222.2009.03281.x
- Issue published online: 10 SEP 2009
- Article first published online: 22 MAY 2009
- Submitted 23 December 2008; revised 18 March 2009; accepted 1 April 2009
- distal lung;
- mast cell;
- perivascular space;
- pulmonary artery
Background To date, little information has been available about pulmonary artery pathology in asthma. The pulmonary artery supplies the distal parts of the lungs and likely represents a site of immunological reaction in allergic inflammation. The objective of this study was to describe the inflammatory cell phenotype of pulmonary artery adventitial inflammation in lung tissue from patients who died of asthma.
Methods We quantified the different inflammatory cell types in the periarterial region of small pulmonary arteries in lung tissue from 22 patients who died of asthma [fatal asthma (FA)] and 10 control subjects. Using immunohistochemistry and image analysis, we quantified the cell density for T lymphocytes (CD3, CD4, CD8), B lymphocytes (CD20), eosinophils, mast cells (chymase and tryptase), and neutrophils in the adventitial layer of pulmonary arteries with a diameter smaller than 500 μm.
Results Our data (median/interquartile range) demonstrated increased cell density of mast cells [FA=271.8 (148.7) cells/mm2; controls=177.0 (130.3) cells/mm2, P=0.026], eosinophils [FA=23.1 (58.6) cells/mm2; controls=0.0 (2.3) cells/mm2, P=0.012], and neutrophils [FA=50.4 (85.5) cells/mm2; controls=2.9 (30.5) cells/mm2, P=0.009] in the periarterial space in FA. No significant differences were found for B and T lymphocytes or CD4+ or CD8+ subsets. Chymase/tryptase positive (MCCT) mast cells predominated over tryptase (MCT) mast cells in the perivascular arterial space in both asthma patients and controls [MCCT/(MCCT+MCT)=0.91 (0–1) in FA and 0.75 (0–1) in controls, P=0.86].
Conclusions Our results show that the adventitial layer of the pulmonary artery participates in the inflammatory process in FA, demonstrating increased infiltration of mast cells, eosinophils, and neutrophils, but not of T and B lymphocytes.