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Time to death, airway wall inflammation and remodelling in fatal asthma

journal contribution
posted on 2023-05-16, 17:19 authored by James, AL, Elliot, JG, Abramson, MJ, Eugene WaltersEugene Walters
Fatal asthma is characterised pathologically by airway wall remodelling, eosinophil and neutrophil infiltration, accumulation of mucus in the airway lumen and smooth muscle shortening. The durations of fatal attacks of asthma show a clear bimodal distribution. Airway smooth muscle contraction and the accumulation of luminal mucus may contribute to death from asthma and relate to time to death. The current authors have examined these two components in uninflated lung tissue in cases of fatal asthma from the second Victorian asthma mortality study. Based on time from onset of symptoms to death, cases fell into two distinct groups: short course <3 (1.5±0.6 mean±SD) h; and long course >8 (12.3±5.9) h. Short course cases had more muscle shortening, higher levels of salbutamol and higher ratios of neutrophils to eosinophils than long course cases, who tended to have more mucus in the lumen. In conclusion, this study confirms the dichotomy of both time to death and the eosinophil/neutrophil ratio in cases of fatal asthma. It suggests that in short course cases acute airway narrowing is due, predominantly, to bronchoconstriction despite higher blood levels of salbutamol. Mucus accumulation may be more important in long course cases. Copyright©ERS Journals Ltd 2005.

History

Publication title

European Respiratory Journal

Volume

26

Pagination

429-434

ISSN

0903-1936

Department/School

Tasmanian School of Medicine

Publisher

EUROPEAN RESPIRATORY SOC JOURNALS LTD,

Place of publication

England

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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