Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood Eosinophils

Background: Blood eosinophil count (BEC) is currently used as a surrogate marker of T2 inflammation in severe asthma but its relationship with tissue T2-related changes is elusive. Bronchial biopsy could add reliable information but lacks standardization. Objectives: To validate a systematic assessm...

Descripción completa

Detalles Bibliográficos
Autores: García-Cosío, Borja, Shafiek, Hanaa, Iglesias, Amanda, Mosteiro, Mar, Gonzalez-Piñeiro, Ana, Rodríguez, Marta, García-Cosío, Mónica, Busto, Eladio, Martin, Javier, Mejías, Luis, Benito, Amparo, López Vilaro, Laura, Gómez Bellvert, Cristina
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/23800
Acceso en línea:https://hdl.handle.net/20.500.12105/23800
Access Level:acceso abierto
Palabra clave:Bronquios
Humanos
Hiperplasia
Inflamación
Asma
Eosinófilos
Eosinofilia
Biopsia
Asthma
Eosinophils
Eosinophilia
Hyperplasia
Humans
Inflammation
Biopsy
Bronchi
id ES_99eeffee8d86ebfdb476ea3ecba7ad3e
oai_identifier_str oai:repisalud.isciii.es:20.500.12105/23800
network_acronym_str ES
network_name_str España
repository_id_str
spelling Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood EosinophilsGarcía-Cosío, BorjaShafiek, HanaaIglesias, AmandaMosteiro, MarGonzalez-Piñeiro, AnaRodríguez, MartaGarcía-Cosío, MónicaBusto, EladioMartin, JavierMejías, LuisBenito, AmparoLópez Vilaro, LauraGómez Bellvert, CristinaBronquiosHumanosHiperplasiaInflamaciónAsmaEosinófilosEosinofiliaBiopsiaAsthmaEosinophilsEosinophiliaHyperplasiaHumansInflammationBiopsyBronchiBackground: Blood eosinophil count (BEC) is currently used as a surrogate marker of T2 inflammation in severe asthma but its relationship with tissue T2-related changes is elusive. Bronchial biopsy could add reliable information but lacks standardization. Objectives: To validate a systematic assessment of the bronchial biopsy for the evaluation of severe uncontrolled asthma (SUA) by standardizing a pathological score. Methods: A systematic assessment of submucosal inflammation, tissue eosinophilic count/field (TEC), goblet cells hyperplasia, epithelial changes, basement membrane thickening, prominent airway smooth muscle and submucosal mucous glands was initially agreed and validated in representative bronchial biopsies of 12 patients with SUA by 8 independent pathologists. In a second phase, 62 patients with SUA who were divided according to BEC≥300cells/mm3 or less underwent bronchoscopy with bronchial biopsies and the correlations between the pathological findings and the clinical characteristics were investigated. Results: The score yielded good agreement among pathologists regarding submucosal eosinophilia, TEC, goblet cells hyperplasia and mucosal glands (ICC=0.85, 0.81, 0.85 and 0.87 respectively). There was a statistically significant correlation between BEC and TEC (r=0.393, p=0.005) that disappeared after correction by oral corticosteroids (OCS) use (r=0.170, p=0.307). However, there was statistically significant correlation between FeNO and TEC (r=0.481, p=0.006) that was maintained after correction to OCS use (r=0.419, p=0.021). 82.4% of low-BEC had submucosal eosinophilia, 50% of them moderate to severe. Conclusion: A standardized assessment of endobronchial biopsy is feasible and could be useful for a better phenotyping of SUA especially in those receiving OCS.20242024-10-0920232023-08-0120232023-08-01research articlehttp://purl.org/coar/resource_type/c_2df8fbb1SMURhttp://purl.org/coar/version/c_71e4c1898caa6e32info:eu-repo/semantics/articlehttps://hdl.handle.net/20.500.12105/23800reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/238002026-06-12T12:43:37Z
dc.title.none.fl_str_mv Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood Eosinophils
title Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood Eosinophils
spellingShingle Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood Eosinophils
García-Cosío, Borja
Bronquios
Humanos
Hiperplasia
Inflamación
Asma
Eosinófilos
Eosinofilia
Biopsia
Asthma
Eosinophils
Eosinophilia
Hyperplasia
Humans
Inflammation
Biopsy
Bronchi
title_short Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood Eosinophils
title_full Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood Eosinophils
title_fullStr Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood Eosinophils
title_full_unstemmed Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood Eosinophils
title_sort Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood Eosinophils
dc.creator.none.fl_str_mv García-Cosío, Borja
Shafiek, Hanaa
Iglesias, Amanda
Mosteiro, Mar
Gonzalez-Piñeiro, Ana
Rodríguez, Marta
García-Cosío, Mónica
Busto, Eladio
Martin, Javier
Mejías, Luis
Benito, Amparo
López Vilaro, Laura
Gómez Bellvert, Cristina
author García-Cosío, Borja
author_facet García-Cosío, Borja
Shafiek, Hanaa
Iglesias, Amanda
Mosteiro, Mar
Gonzalez-Piñeiro, Ana
Rodríguez, Marta
García-Cosío, Mónica
Busto, Eladio
Martin, Javier
Mejías, Luis
Benito, Amparo
López Vilaro, Laura
Gómez Bellvert, Cristina
author_role author
author2 Shafiek, Hanaa
Iglesias, Amanda
Mosteiro, Mar
Gonzalez-Piñeiro, Ana
Rodríguez, Marta
García-Cosío, Mónica
Busto, Eladio
Martin, Javier
Mejías, Luis
Benito, Amparo
López Vilaro, Laura
Gómez Bellvert, Cristina
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Bronquios
Humanos
Hiperplasia
Inflamación
Asma
Eosinófilos
Eosinofilia
Biopsia
Asthma
Eosinophils
Eosinophilia
Hyperplasia
Humans
Inflammation
Biopsy
Bronchi
topic Bronquios
Humanos
Hiperplasia
Inflamación
Asma
Eosinófilos
Eosinofilia
Biopsia
Asthma
Eosinophils
Eosinophilia
Hyperplasia
Humans
Inflammation
Biopsy
Bronchi
description Background: Blood eosinophil count (BEC) is currently used as a surrogate marker of T2 inflammation in severe asthma but its relationship with tissue T2-related changes is elusive. Bronchial biopsy could add reliable information but lacks standardization. Objectives: To validate a systematic assessment of the bronchial biopsy for the evaluation of severe uncontrolled asthma (SUA) by standardizing a pathological score. Methods: A systematic assessment of submucosal inflammation, tissue eosinophilic count/field (TEC), goblet cells hyperplasia, epithelial changes, basement membrane thickening, prominent airway smooth muscle and submucosal mucous glands was initially agreed and validated in representative bronchial biopsies of 12 patients with SUA by 8 independent pathologists. In a second phase, 62 patients with SUA who were divided according to BEC≥300cells/mm3 or less underwent bronchoscopy with bronchial biopsies and the correlations between the pathological findings and the clinical characteristics were investigated. Results: The score yielded good agreement among pathologists regarding submucosal eosinophilia, TEC, goblet cells hyperplasia and mucosal glands (ICC=0.85, 0.81, 0.85 and 0.87 respectively). There was a statistically significant correlation between BEC and TEC (r=0.393, p=0.005) that disappeared after correction by oral corticosteroids (OCS) use (r=0.170, p=0.307). However, there was statistically significant correlation between FeNO and TEC (r=0.481, p=0.006) that was maintained after correction to OCS use (r=0.419, p=0.021). 82.4% of low-BEC had submucosal eosinophilia, 50% of them moderate to severe. Conclusion: A standardized assessment of endobronchial biopsy is feasible and could be useful for a better phenotyping of SUA especially in those receiving OCS.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-08-01
2023
2023-08-01
2024
2024-10-09
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
SMUR
http://purl.org/coar/version/c_71e4c1898caa6e32
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.12105/23800
url https://hdl.handle.net/20.500.12105/23800
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869414330089340928
score 15,81155

Similares en LA Referencia