Abstract

<b>Background:</b> Bronchial remodeling is a key feature of asthma already present in preschool wheezers. Bronchial smooth muscle (BSM) remodeling at preschool age is predictive of asthma at school age. However, the mechanism responsible for BSM remodeling in preschool wheezers remains totally unknown. By contrast, in adult asthma, BSM remodeling has been associated to an increase in BSM cell proliferation related to increased mitochondrial mass and biogenesis triggered by an altered calcium homeostasis. Indeed, BSM cell proliferation was decreased in vitro by the calcium channel blocker gallopamil. <b>Objective:</b> To investigate the mechanisms involved in BSM cell proliferation in severe preschool wheezers, with special attention to the role of mitochondria and calcium signaling. <b>Methods:</b> Bronchial tissue obtained from 12 non-wheezing preschool controls and 10 severe preschool wheezers, was used to measure BSM mass and establish primary BSM cell cultures. BSM cell proliferation was assessed by manual counting and flow cytometry, mitochondrial mass and biogenesis by immunoblotting, ATP content by bioluminescence and calcium response to carbachol by confocal microscopy. The effect of gallopamil was also evaluated. <b>Results:</b> BSM mass, BSM cell proliferation, ATP content, mitochondrial mass and biogenesis, as well as calcium response were all increased in severe preschool wheezers compared to those of controls. Gallopamil significantly decreased BSM mitochondrial biogenesis and mass, and cell proliferation. <b>Conclusion:</b> Mitochondria act as a key player in BSM cell proliferation in severe preschool wheezers and could thus represent a potential target to treat&nbsp;BSM remodeling at early stage of the disease.

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