title: Proliferation and inflammation in bronchial epithelium after allergen in atopic asthmatics.
abstract: BACKGROUND
  The mechanisms that regulate epithelial integrity and repair in asthma are poorly understood. We hypothesized that allergen exposure could alter epithelial inflammation, damage and proliferation in atopic asthma.
  
  
  OBJECTIVE
  We studied epithelial cell infiltration, shedding, expression of the proliferation marker Ki-67 and the epithelial cell-cell adhesion molecules Ep-CAM and E-cadherin in bronchial biopsies of 10 atopic mild asthmatics 48 h after experimental diluent (D) and allergen (A) challenge in a cross-over design.
  
  
  METHODS
  Epithelial shedding, expressed as percentage of not intact epithelium, Ki-67+, eosinophil/EG-2+, CD4+ and CD8+ cells were quantified by image analysis in bronchial epithelium, and adhesion molecules were analysed semi-quantitatively.
  
  
  RESULTS
  Epithelial shedding was not altered by A (D: 88.1+/-3.1% vs. A: 89.2+/-3.7%; P=0.63). The numbers of Ki-67+ epithelial (D: 10.2+/-0.2 vs. A: 19.9+/-0.3 cells/mm; P=0.03), EG-2+ (D: 4.3+/-0.5 vs. A: 27+/-0.3 cells/mm; P=0.04) and CD4+ cells (D: 1.7+/-1.2 vs. A: 12.3+/-0.6 cells/mm; P=0.04) were significantly increased after A, whilst CD8+ numbers were not significantly changed (P>0.05). E-cadherin and Ep-CAM epithelial staining showed a similar intensity after D and A (P>0.05). We found a positive correlation between EG-2+ and Ki-67+ cells in the epithelium (Rs: 0.63; P=0.02).
  
  
  CONCLUSIONS
  Our study indicates that allergen challenge increases epithelial proliferation in conjunction with inflammation at 2 days after exposure. This favours the hypothesis that long-lasting epithelial restitution is involved in the pathogenesis of asthma.
authors.affiliation: Department of Pulmonology, Leiden University Medical Center, The Netherlands. ricciardolo@virgilio.it
authors.forename: F L M
authors.initials: FL
authors.lastname: Ricciardolo
authors.forename: A
authors.initials: A
authors.lastname: Di Stefano
authors.forename: J H J M
authors.initials: JH
authors.lastname: van Krieken
authors.forename: J K
authors.initials: JK
authors.lastname: Sont
authors.forename: A
authors.initials: A
authors.lastname: van Schadewijk
authors.forename: K F
authors.initials: KF
authors.lastname: Rabe
authors.forename: C F
authors.initials: CF
authors.lastname: Donner
authors.forename: P S
authors.initials: PS
authors.lastname: Hiemstra
authors.forename: P J
authors.initials: PJ
authors.lastname: Sterk
authors.forename: T
authors.initials: T
authors.lastname: Mauad
mesh_terms: D000328:Adult; D000485:Allergens; D000951:Antigens, Neoplasm / Q000378:metabolism; D001249:Asthma / Q000473:pathology* / Q000503:physiopathology; D001980:Bronchi; D001991:Bronchitis / Q000473:pathology; D015820:Cadherins; D015815:Cell Adhesion Molecules / Q000378:metabolism; D002455:Cell Division; D018592:Cross-Over Studies; D004391:Dust; D000071858:Epithelial Cell Adhesion Molecule; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D020545:Respiratory Mucosa / Q000473:pathology
chemical_list: D000485:Allergens; D000951:Antigens, Neoplasm; D015820:Cadherins; D015815:Cell Adhesion Molecules; D004391:Dust; D000071858:Epithelial Cell Adhesion Molecule; D019394:Ki-67 Antigen