title: Expression of the apoptosis inhibitor Bcl-2 in sputum eosinophils from children with acute asthma.
abstract: BACKGROUND
  Apoptosis of eosinophils is of increasingly important value in modulating allergic airway inflammation in asthma. Our purpose was to investigate the degree of expression of the antiapoptotic B-cell lymphoma/leukaemia-2 (Bcl-2) protein in sputum eosinophils during acute asthma exacerbation and its relationship with exacerbation severity.
  
  
  METHODS
  Sputum was obtained from 33 asthmatic children and 15 healthy children as a control group. Patients were studied during an acute asthma exacerbation. They were classified according to the severity of exacerbation into mild, moderate and severe (n=11 for each). Patients with severe exacerbation were followed up until remission and another sputum sample was obtained. Number of sputum eosinophils was expressed as percentage of leucocytes. Bcl-2 expression in sputum eosinophils was assessed by immunohistochemical staining techniques; the results were expressed as percentage of positively stained cells over total eosinophils.
  
  
  RESULTS
  Sputum eosinophils and Bcl-2(+) eosinophils' percentages were significantly higher in patients with acute exacerbation than controls (P<0.01). Patients with severe exacerbation had significantly higher sputum Bcl-2(+) eosinophils' percentage than those with mild-to-moderate exacerbation (mean+/-SD=42.4+/-31.96% vs. 5.7+/-14.5%, P<0.01). A significant negative correlation was found between Bcl-2(+) eosinophils' percentage and peak expiratory flow rate % predicted (P<0.05). After remission, patients with severe exacerbation showed a significant decrease of Bcl-2(+) eosinophils' percentage (P<0.05).
  
  
  CONCLUSIONS
  Our findings suggest that Bcl-2 prolongs survival and decreases apoptosis of airway eosinophils in asthma especially during exacerbation. Eosinophil apoptosis and Bcl-2 represent a target for new and effective therapeutic strategies of asthma.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt. yehiamelgamal@hotmail.com
authors.forename: Y
authors.initials: Y
authors.lastname: El-Gamal
authors.forename: N
authors.initials: N
authors.lastname: Heshmat
authors.forename: M
authors.initials: M
authors.lastname: Mahran
authors.forename: Z
authors.initials: Z
authors.lastname: El-Gabbas
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D017209:Apoptosis; D001249:Asthma / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004804:Eosinophils / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D010366:Peak Expiratory Flow Rate; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism*; D012720:Severity of Illness Index; D013183:Sputum / Q000166:cytology / Q000378:metabolism*
chemical_list: D019253:Proto-Oncogene Proteins c-bcl-2