Increased mast cells and neutrophils in submucosal mucous glands and mucus plugging in patients with asthma

N G Carroll, S Mutavdzic, A L James, N G Carroll, S Mutavdzic, A L James

Abstract

Background: Mucus plugging of the airways is invariably seen in cases of fatal asthma, mucus production is associated with asthma attacks, and the area of submucosal glands is increased in asthma. Mediators secreted from mast cells and neutrophils can stimulate mucous gland secretion. A study was undertaken to count the mast cells and neutrophils in submucosal glands and to relate cell numbers to the presence of mucus in the airway lumen.

Methods: Cartilaginous airways obtained at necropsy from cases of fatal asthma (n=8), non-fatal asthma (n=8), and control cases (n=8) were examined. Contiguous transverse sections were stained for mast cell tryptase and neutrophil elastase, and with Periodic Acid Schiff solution to identify mucus. Mucous gland area, lumen area, and the percentage of the relaxed lumen area occupied by mucus (mucus occupying ratio, MOR) were measured. Mast cells (intact and degranulated) and neutrophils per area of submucosal gland were calculated.

Results: Compared with controls, the cases of fatal asthma had increased mucous gland area, MOR, percentage of degranulated mast cells, and numbers of neutrophils in the submucosal glands (p<0.05). In cases of non-fatal asthma the MOR and the numbers of mast cells and neutrophils in the submucosal glands were increased (p<0.05). When all cases were pooled together, the MOR correlated with the total number of mast cells (r=0.55, p=0.005) and with the number of degranulated mast cells in the submucosal glands (r=0.51, p=0.013), but not with the number of neutrophils (r=0.21, p=0.121).

Conclusion: These results show that mucous gland area, MOR, and mucous gland inflammation are increased in asthma and that degranulation of mast cells may contribute to secretion of mucus into the lumen in cases of fatal asthma.

References

    1. Thorax. 1968 Mar;23(2):168-72
    1. J Clin Pathol. 1960 Jan;13:27-33
    1. JAMA. 1971 Feb 1;215(5):769-76
    1. Br Med J (Clin Res Ed). 1985 Nov 2;291(6504):1235-9
    1. Am Rev Respir Dis. 1989 Jan;139(1):242-6
    1. Am Rev Respir Dis. 1991 Jan;143(1):138-43
    1. Am Rev Respir Dis. 1991 Sep;144(3 Pt 2):S48-51
    1. Am Rev Respir Dis. 1992 Mar;145(3):669-74
    1. Am Rev Respir Dis. 1992 Apr;145(4 Pt 1):890-9
    1. Chest. 1992 Apr;101(4):916-21
    1. Clin Exp Allergy. 1992 May;22(5):525-32
    1. Am Rev Respir Dis. 1993 Feb;147(2):405-10
    1. Am Rev Respir Dis. 1993 Jun;147(6 Pt 1):1557-61
    1. Am J Respir Crit Care Med. 1994 May;149(5):1311-6
    1. Am J Respir Crit Care Med. 1994 Jul;150(1):17-22
    1. Am J Respir Crit Care Med. 1996 Feb;153(2):551-6
    1. Eur Respir J. 1996 Apr;9(4):709-15
    1. Eur Respir J. 1997 Feb;10(2):292-300
    1. Am J Respir Crit Care Med. 1997 Mar;155(3):1123-9
    1. Am J Respir Crit Care Med. 1998 Feb;157(2):610-6
    1. J Allergy. 1952 May;23(3):193-203
    1. Dis Chest. 1960 Dec;38:616-24
    1. Istanbul Tip Fak Mecmuasi. 1960 Jun;23:142-53
    1. Thorax. 1969 Mar;24(2):176-9

Source: PubMed

3
Abonner