Effects of budesonide and formoterol on allergen-induced airway responses, inflammation, and airway remodeling in asthma

Effect of study treatment on allergen-induced early (EAR) and late (LAR) asthmatic responses.

Effect of study treatment on AHR (MCh PC₂₀) before (day 8) and after (day 11) allergen challenge.

Effect of study treatment on sputum eosinophil numbers before (day 8) and 7 hours (day 9) and 48 hours (day 11) after allergen challenge.

Smooth muscle (percentage of area) and numbers of myofibroblasts in the subepithelial compartment in bronchial biopsy specimens. Box plots represent the medians and IQRs.

Study protocol. CBC, Complete blood count; INR, international normalized ratio.

Numbers of intraepithelial (A) and subepithelial (B) eosinophils in bronchial biopsy samples. Box plots represent medians and IQRs.

Immunohistochemistry to detect α-SMA in myofibroblasts (A and B, brown stain). Transmission electron microscopy of area rich in myofibroblasts (C and D). The similar morphology of myofibroblasts when viewed under light microscopy and low-power transmission electron microscopy can be appreciated by comparing Fig E3, B, and Fig E3, C. Fig E3, D and E, represent high-power photomicrographs of the area seen in Fig E3, C, which confirms the ultrastructural features of myofibroblasts. White arrows indicate microfilament bundles within myofibroblast cytoplasm. Original magnification: Fig E3, A, ×200; Fig E3, B, ×400. The bar in Fig E3, C, represents 20 μm, and the bar in Fig E3, D and E, represents 1 μm. EP, Epithelium.

Immunohistochemistry directed against α-SMA in myofibroblasts and smooth muscle (brown stain). A and B, Areas of possible transition between smooth muscle (sm) cells and myofibroblasts (mf; ^∗). The epithelial surface (ep) has been mostly stripped away, with only the basal layer intact. C, Myofibroblasts within the submucosa that have a similar orientation and appear to form a syncytium. Original magnification: ×200 for left-sided panels and ×400 for right-sided panels.

Immunohistochemistry to detect α-SMA in smooth muscle (A and B, brown stain). Transmission electron microscopy of smooth muscle (C and D). The similar morphology of smooth muscle bundles when viewed under light microscopy and low-power transmission electron microscopy can be appreciated by comparing Fig E5, B, and Fig E5, C. Fig E5, D, represents a high-power photomicrograph of Fig E5, C, which confirms the ultrastructural features of smooth muscle. Original magnification: Fig E5, A, ×60; Fig E5, B, ×400. The bar in Fig E5, C, represents 20 μm, and the bar in Fig E5, D, represents 1 μm. SM, Smooth muscle; BV, blood vessel.

Special stains for eosinophils (A; Congo Red, red stain), CD3⁺ lymphocytes (B; anti-CD3, brown stain), plasma cells (C; anti-CD138, brown stain), and neutrophils (D; anti-neutrophil elastase, brown stain). Original magnification: Fig E6, A, ×400; Fig E6, B, ×400; Fig E6, C, ×400; and Fig E6, D, ×60. Anti-CD138 stains the basal bronchial epithelial cells, as well as the plasma cells. Arrows indicate cells of interest. SM, Smooth muscle; EP, bronchial epithelium.

Special stains for mast cells (anti-tryptase, brown stain). Original magnification: A, ×60; B, ×400. Arrows indicate cells of interest. SM, Smooth muscle; EP, bronchial epithelium.