Airway eosinophilia in remission and progression of asthma: Accumulation with a fast decline of FEV1

M. Broekema, F. Volbeda, W. Timens, A. Dijkstra, N. A. Lee, J. J. Lee, M. E. Lodewijk, D. S. Postma, M. N. Hylkema, N. H.T. Ten Hacken

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Background: As it is unknown whether complete asthma remission or progression of asthma is associated with airway inflammation and remodeling, we assessed these characteristics in bronchial biopsies of relevant subsets of asthma patients. Methods: Sputum and bronchial biopsies were obtained from asthma patients in remission (PC20 histamine > 32 mg/ml, PC 20 AMP > 320 mg/ml) and from those with either a slow FEV 1 decline (<30 ml/year) or fast decline (>30 ml/year). Inflammatory cells and mediators were determined in sputum, inflammatory cells and aspects of airway remodeling in bronchial biopsies. Results: Asthmatics in remission and asthma patients with a slow FEV1 decline had a similar extent of airway inflammation and remodeling in sputum and bronchial biopsies. Asthma patients with a fast FEV1 decline had high sputum eosinophil numbers. Moreover, FEV1 decline (ml/year) correlated with sputum eosinophil numbers (Rs = 0.51, p = 0.003) and ECP levels (Rs = 0.57, p = 0.001). Airway remodeling, i.e. basement membrane thickness, correlated with sputum eosinophils (Rs = 0.69, p < 0.001), sputum ECP (Rs = 0.46, p = 0.018) and airway wall eosinophil numbers (Rs = 0.49, p = 0.002). Conclusions: Asthma, even when in remission, is accompanied by airway inflammation and remodeling. Data suggest that eosinophils are important in a subset of asthma patients by association to accelerated FEV1 decline and change of basement membrane thickness.

Original languageEnglish (US)
Pages (from-to)1254-1262
Number of pages9
JournalRespiratory Medicine
Issue number9
StatePublished - Sep 2010


  • Airway inflammation
  • Airway remodeling
  • Eosinophils
  • Lung function decline

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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