title: The clinical utility of reticular basement membrane thickness measurements in asthmatic children.
abstract: OBJECTIVE
  Reticular basement membrane (RBM) thickness is one of the pathological features of asthma and can be measured in endobronchial biopsies. We assessed the feasibility of endobronchial biopsies in a routine clinical setting and investigated the clinical value of RBM thickness measurements for asthma diagnosis in children.
  
  
  METHODS
  We included all children who underwent bronchoscopy with endobronchial mucosal biopsies for clinical reasons and divided them into three subgroups: (1) no asthma, (2) mild-moderate asthma, and (3) problematic severe asthma.
  
  
  RESULTS
  In 152/214 (71%) patients, mean age 9.5 years (SD 4.6; range 0.1-18.7) adequate biopsies were retrieved in which RBM thickness could be measured. Mean (SD) RBM thickness differed significantly among children without asthma, with mild-moderate asthma, and with problematic severe asthma (p = 0.04), 4.68 (1.24) µm, 4.56 (0.89) µm, and 5.21 (1.10) µm respectively. This difference disappeared after adding exhaled nitric oxide to the multivariate model.
  
  
  CONCLUSIONS
  This study confirms the difference in RBM thickness between children with and without asthma and between asthma severities in a routine clinical care setting. However, quantifying the RBM thickness appeared to have no added clinical diagnostic value for asthma in children.
authors.affiliation: a Department of Pediatric Pulmonology, Erasmus Medical Centre , Sophia Children's Hospital , Rotterdam , The Netherlands .
authors.forename: Esther
authors.initials: E
authors.lastname: van Mastrigt
authors.affiliation: a Department of Pediatric Pulmonology, Erasmus Medical Centre , Sophia Children's Hospital , Rotterdam , The Netherlands .|b Department of Pathology , Erasmus Medical Centre , Rotterdam , The Netherlands .
authors.forename: Leonie
authors.initials: L
authors.lastname: Vanlaeken
authors.affiliation: c Department of Pathology and Medical Biology , University of Groningen, University Medical Centre Groningen , Groningen , The Netherlands , and.|d Department of Pediatric Pulmonology , University of Groningen, University Medical Centre, Beatrix Children's Hospital , Groningen , The Netherlands.
authors.forename: Fardou
authors.initials: F
authors.lastname: Heida
authors.affiliation: a Department of Pediatric Pulmonology, Erasmus Medical Centre , Sophia Children's Hospital , Rotterdam , The Netherlands .
authors.forename: Daan
authors.initials: D
authors.lastname: Caudri
authors.affiliation: a Department of Pediatric Pulmonology, Erasmus Medical Centre , Sophia Children's Hospital , Rotterdam , The Netherlands .
authors.forename: Johan C
authors.initials: JC
authors.lastname: de Jongste
authors.affiliation: c Department of Pathology and Medical Biology , University of Groningen, University Medical Centre Groningen , Groningen , The Netherlands , and.
authors.forename: Wim
authors.initials: W
authors.lastname: Timens
authors.affiliation: d Department of Pediatric Pulmonology , University of Groningen, University Medical Centre, Beatrix Children's Hospital , Groningen , The Netherlands.
authors.forename: Bart L
authors.initials: BL
authors.lastname: Rottier
authors.affiliation: b Department of Pathology , Erasmus Medical Centre , Rotterdam , The Netherlands .
authors.forename: Ronald R de
authors.initials: RR
authors.lastname: Krijger
authors.affiliation: a Department of Pediatric Pulmonology, Erasmus Medical Centre , Sophia Children's Hospital , Rotterdam , The Netherlands .
authors.forename: Mariëlle W
authors.initials: MW
authors.lastname: Pijnenburg
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000473:pathology*; D001485:Basement Membrane / Q000473:pathology*; D001706:Biopsy; D001944:Breath Tests; D001980:Bronchi / Q000473:pathology*; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007223:Infant; D008297:Male; D009569:Nitric Oxide; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D009569:Nitric Oxide
keywords: Childhood asthma; endobronchial biopsy; exhaled nitric oxide; pediatrics; remodeling