TY - JOUR T1 - Mast cell infiltration and epithelial damage in children with episodic wheezing JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - 5025 AU - Graziella Turato AU - Simonetta Baraldo AU - Elena Mutti AU - Emanuela Rossi AU - Erica Bazzan AU - Serena Calgaro AU - Deborah Snijders AU - Angelo Barbato AU - Marina Saetta Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/5025.abstract N2 - Rationale Wheezing is the most frequent clinical manifestation of asthma early in life, however is not specific since infants can have episodes of wheezing associated with viral infections. Neither the pathogenesis of these episodes nor their relation to classic asthma has been completely elucidated. Aim The aim of this study was to compare the airway pathology of children with wheezing only during viral infections i.e “episodic wheeze”, to that of children with wheezing not only during viral infections but also in between i.e.“multitrigger wheeze” that often evolves into asthma. Methods Bronchial biopsies were taken in 7 children with episodic wheeze, 18 with multitrigger wheeze and 7 controls who underwent bronchoscopy for appropriate clinical indications and analyzed by immunohistochemistry. Results Eosinophil infiltration was increased in multitrigger wheeze compared to controls (90;0-267 vs 9; 0-50 cells/mm2;p=0.007), but not in episodic wheeze (25;0-586). Mast cells were increased in the multitrigger and episodic wheeze groups (410; 113-755 and 460;183-750 cells/mm2) when compared to controls (144; 63-612; p=0.03). Epithelial damage was present in higher proportion in episodic and multitrigger wheeze children than in controls (65 vs 92% vs 37%) but the difference was not statistically significant. In the population as a whole, the number of mast cells positively correlated with the degree of epithelial damage (r=0.5, p=0.005). Conclusion The presence of mast cells along with epithelial damage might represent the anatomical basis for the intermittent wheezing in childhood. The presence of eosinophils along with mast cells might predispose to multitrigger wheeze in childhood and eventually asthma. ER -