TY - JOUR T1 - IL-33 and airway remodelling in paediatric severe therapy resistant asthma JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - 4709 AU - Nicola Ullmann AU - Alex Adams AU - Cara J. Bossley AU - Tim Oates AU - Claire M. Lloyd AU - Andy Bush AU - Sejal Saglani Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/4709.abstract N2 - BackgroundAssociations have been reported between epithelial interleukin (IL)-33 expression and severe asthma in adults, but its role in the pathophysiology of paediatric severe therapy resistant asthma (STRA) remains unknown.ObjectivesWe quantified IL-33 expression in endobronchial biopsies from children with STRA and explored its relationship with parameters of airway remodelling.MethodsChildren (n=45) (median age 11.3 [range 5.4-16.4] years) with STRA underwent detailed investigations including bronchoscopy and endobronchial biopsy. IL-33+ cells were quantified in the epithelium, smooth muscle and submucosa in biopsies from children with STRA and compared to that in age matched non-asthmatic controls. Reticular basement membrane (RBM) thickness was quantified as a marker of airway remodelling, and related to IL-33+ cells.ResultsSubmucosal, but not epithelial or smooth muscle IL-33+ cells were significantly higher in children with STRA compared to controls (p=0.01, 0.21, 0.68 respectively).In addition, there was a positive correlation between IL-33+ cells and RBM thickness in children with STRA (Spearman r=0.35, p=0.018), but not in controls (p=0.33).Conclusions In contrast to adult studies, we have shown increased submucosal IL-33 expression in children with STRA, and for the first time have shown an association between this mediator and airway remodelling. These data suggest therapies that block IL-33 may be suitable for paediatric STRA, and specifically may impact on structural airway changes. ER -