Airway wall remodeling after cessation of exposure to isocyanates in sensitized asthmatic subjects.

M Saetta, P Maestrelli, G Turato, CE Mapp… - American journal of …, 1995 - atsjournals.org
M Saetta, P Maestrelli, G Turato, CE Mapp, G Milani, F Pivirotto, LM Fabbri, A Di Stefano
American journal of respiratory and critical care medicine, 1995atsjournals.org
To determine whether the cessation of exposure to isocyanates is associated with structural
changes of the airway wall in sensitized subjects, we studied bronchial biopsies from 10
subjects with occupational asthma induced by toluene diisocyanate (TDI). Bronchial
challenges with TDI and methacholine were performed and biopsies were taken on two
occasions, at diagnosis and 6 to 21 mo after cessation of exposure to TDI. After
bronchoscopy, biopsies were formalin-fixed or snap-frozen in liquid nitrogen and then …
To determine whether the cessation of exposure to isocyanates is associated with structural changes of the airway wall in sensitized subjects, we studied bronchial biopsies from 10 subjects with occupational asthma induced by toluene diisocyanate (TDI). Bronchial challenges with TDI and methacholine were performed and biopsies were taken on two occasions, at diagnosis and 6 to 21 mo after cessation of exposure to TDI. After bronchoscopy, biopsies were formalin-fixed or snap-frozen in liquid nitrogen and then processed for a quantitative histochemical and immunohistochemical analysis. After cessation of exposure, we observed a significant decrease of the sensitivity to TDI (p < 0.05), of the thickness of subepithelial fibrosis (p < 0.007), and of the numbers of subepithelial fibroblasts (p < 0.05), mast cells (p < 0.02), and lymphocytes (p < 0.03) as compared with values at diagnosis. By contrast, the nonspecific bronchial hyperresponsiveness and the numbers of macrophages and eosinophils did not change. In conclusion, in patients with occupational asthma induced by TDI, the cessation of exposure to the sensitizing agent is associated with a reduced thickness of subepithelial fibrosis and with a reduced number of subepithelial fibroblasts, mast cells, and lymphocytes in the bronchial mucosa, suggesting a remodeling of the airway wall with the avoidance of the specific stimulus.
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