ORIGINAL ARTICLE

NASAL MUCOSA CELLULAR INFILTRATES IN DIFFERENT PHENOTYPES
OF ASTHMATIC CHILDREN: A BRUSH BIOPSY STUDY

Malak Shaheen,¹ Manal Salman,² Mohamed Elkhouly^3
1Pediatric Department, ²Pathology Department, Ain Shams Faculty of Medicine, ³Pediatric Department, Banha Training Hospital, Egypt

Correspondence to: Malak Shaheen, Email: childshaheen@yahoo.com

Background: Little is known about the cellular infiltrates in nasal mucosa of asthmatic children subtypes.
Aim of the work: This study was set up to compare the nasal cellular infiltrates using brush biopsy specimens from asthmatic children of different severities and with or without allergic rhinitis.

Methods: Thirty asthmatic children (15 children with allergic rhinitis and 15 children without allergic rhinitis) and 10 agematched healthy control children were evaluated. All included children were subjected to the following; full medical history, thorough clinical examination, basic spirometric FEV1 (forced expiratory volume in 1 second), nasal mucosal brush biopsies
and assessment of total serum immunoglobulin (Ig) E.

Results: A significantly higher numbers of nasal mucosal eosinophils and neutrophils were detected in all asthmatic children
compared to controls (p <0.01 and p <0.05 respectively) with best cut off value 7 cells/HPF and 9.5 cells/HPF respectively.
Nasal cellular infiltrates discriminate asthma severity and presence of concomitant allergic rhinitis within asthmatic subgroups with cut off values. Eosinophils and neutrophils best cut off values between mild and moderate asthmatics are 17.5 cells/HPF and 9.5 cells/HPF respectively. Eosinophils and neutrophils best cut off values between moderate and severe asthmatics are 50.5 cells/HPF and 52 cells/HPF respectively. Presence of concomitant allergic rhinitis was defined with eosinophils and neutrophils nasal mucosal infiltrates more than 47.5 cells/HPF and 45 cells/HPF respectively.

In conclusion: These results show that the nasal cellular infiltrates of asthmatic children differ from healthy controls and within asthmatics subtypes. Cut off values of nasal cellular infiltrates may aid to predict asthma severity and/or presence of concomitant allergic rhinitis.

Keywords: Asthma, children, phenotypes, nasal mucosa, cellular infiltrates.

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