Studies of bronchial asthma Part 2. Studies of the changes in the peripheral airway of asthmatic patients by selective alveolo-bronchography (SAB)

In order to investigate changes in the peripheral airway of asthmatics, selective aveolobronchography (SAB) was performed in 33 cases of asthma. SAB findings were studied in respect to the classification of asthma and also examined with results of pulmonary function test, bronchoalveolar lavage (BAL) and transbronchial lung biopsy. 1. Narrowing of the central airway was observed in almost all cases and 19 cases showed narrowing of the peripheral airways. An uneven appearance of the alveolar figure was observed in 11 cases. 2. Narrowing of the peripheral airway and an uneven appearance of the alveolar figure were often observed in non-atopic patients, in moderate or severe cases and in late-onset asthmatics. 3. The mean value of V(50)/V(25) was increased and the mean value of %V(25) was decreased in patients with narrowing of the peripheral airways and also in patients with uneven appearance of the alveolar figure. 4. An increase of neutrophils was noticed in the BAL fluid of patients with narrowing of the peripheral airways. 5. With histological study by TBLB, infiltration of eosinophils into the alveoli as well as mononuclear cells into alveoli and bronchioli was demonstrated in patients with narrowing of the peripheral airways.