title: Increased epidermal growth factor in nasopharyngeal aspirates from infants with recurrent wheeze.
abstract: Airway remodeling is known to be a consequence of repeated injury and thought to be involved in early stage of asthma. We aimed to investigate the mediators associated with airway remodeling in recurrent early wheezers. Thirty-three infants, aged 2 years or less, admitted with exacerbation of wheezing were enrolled. All of them had experienced three or more episodes of wheezing before admission. They were categorized into two groups: those who had been hospitalized two or more times for severe wheezing (N = 19) and those who had only once or never been hospitalized (N = 14). Epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), and transforming growth factor (TGF)-β1 levels in nasopharyngeal aspirates (NPA) collected on admission were measured. The difference between two patients groups divided based on their hospitalization history was assessed. We also examined these mediators in older asthmatic children (N = 15) admitted with exacerbation and their relationship with lung function parameters measured after stabilization. NPA EGF levels were significantly increased in recurrent early wheezers compared to controls. EGF, VEGF, and TGF-β1 levels were significantly higher in those with a previous history of multiple hospitalizations than in those without. In older asthmatic children, EGF levels were related with age and duration of asthma, but showed an inverse correlation with forced expiratory volume in 1 sec and forced expiratory flow between 25% and 75% of vital capacity. Our study shows that there might be significant damage during exacerbation in wheezy infants as levels of the mediators, EGF, VEGF, and TGF-β1 were higher in those who had been frequently hospitalized. It seems to suggest that those infants with severe recurrent wheezing might have chronic airway obstruction.
authors.affiliation: Department of Pediatrics, School of Medicine, Catholic University of Taegu, Taegu, Korea.
authors.forename: Hai Lee
authors.initials: HL
authors.lastname: Chung
authors.affiliation: Department of Pediatrics, School of Medicine, Catholic University of Taegu, Taegu, Korea.
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, School of Medicine, Catholic University of Taegu, Taegu, Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Pediatrics, School of Medicine, Catholic University of Taegu, Taegu, Korea.
authors.forename: Kye Hyang
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000367:Age Factors; D001249:Asthma / Q000378:metabolism; D016022:Case-Control Studies; D002675:Child, Preschool; D004815:Epidermal Growth Factor / Q000378:metabolism*; D005260:Female; D005540:Forced Expiratory Flow Rates; D005541:Forced Expiratory Volume; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D009296:Nasal Cavity / Q000378:metabolism*; D010614:Pharynx / Q000378:metabolism*; D012008:Recurrence; D012135:Respiratory Sounds; D053773:Transforming Growth Factor beta1 / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D053773:Transforming Growth Factor beta1; D042461:Vascular Endothelial Growth Factor A; D004815:Epidermal Growth Factor
keywords: asthma & early wheeze; early wheezers; epidermal growth factor; transforming growth factor-β1; vascular endothelial growth factor