2026-04-29T02:37:41Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/238002024-10-09T06:36:33Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967
Repisalud
author
García-Cosío, Borja
author
Shafiek, Hanaa
author
Iglesias, Amanda
author
Mosteiro, Mar
author
Gonzalez-Piñeiro, Ana
author
Rodríguez, Marta
author
García-Cosío, Mónica
author
Busto, Eladio
author
Martin, Javier
author
Mejías, Luis
author
Benito, Amparo
author
López Vilaro, Laura
author
Gómez Bellvert, Cristina
2024-10-09T06:36:33Z
2024-10-09T06:36:33Z
2023-08
Cosio BG, Shafiek H, Iglesias A, Mosteiro M, Gonzalez-Piñeiro A, Rodríguez M, et al. Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood Eosinophils. Arch Bronconeumol. 2023 Aug;59(8):502-9.
https://hdl.handle.net/20.500.13003/19960
https://hdl.handle.net/20.500.12105/23800
37414638
10.1016/j.arbres.2023.05.014
1579-2129
Archivos de bronconeumologia
2-s2.0-85164314037
1067514000001
L2025551404
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.
eng
Validation of a Pathological Score for the Assessment of Bronchial Biopsies in Severe Uncontrolled Asthma: Beyond Blood Eosinophils
research article