الفهرس 
Introduction&Aim of the workOnly 14 pages are availabe for public view
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Abstract
The present study included 20 atopic asthmatic patients, 5 males and 15 females, 14 were residents in rural areas and 6 in urban areas. The age of the studied cases ranged between 17 and 47 years with mean of 31.95 ¬¬± 9.61 y. (10 mild asthmatics and 10 moderate asthmatics). All cases were subjected to thorough history taking and clinical examination, fiberoptic bronchoscopy with segmental bronchoprovocation (SBP) and bronchial biopsies that were taken at baseline (before SBP), 10-20 min after SBP, and 24h after SBP. This work was planned to study mast cells apoptosis, degranulation and tissue load of bronchial mucosa following local endobronchial allergen challenge in asthmatic patients. The most frequent aeroallergen detected and used for SBP in this study was the mixed pollen allergen that was found to be allergic to 4 patients and three patients were allergic to mite antigen. The results revealed: a) Mast cells load: • There was a significant increase in mast cell load in EPR and LPR in comparison to the baseline mast cell load in all cases. • There was no statistically significant difference in mast cell load between EPR and LPR. • No significant difference in mast cell load in mild versus moderate asthma in baseline and EPR bronchial mucosal biopsies, • But there was a significant increase in LPR mast cell load in moderate asthma than that in mild asthma. b) Mast cell degranulation: • There was a significant increase in the degree of degranulation of mast cells in both EPR and LPR in relation to the baseline mast cells, and a significant increase of degranulating mast cells percentage in LPR in relation to EPR. • There was no significant difference of mast cells degranulation percentages in baseline, EPR, and LPR bronchial mucosal biopsies,in both mild and moderate asthma. c) Mast cell apoptosis: • In all studied cases: The apoptosis percentage in Basal line, EPR, and LPR were (35%), (25%), and (40%) respectively. Although the EPR had the lowest percentage of apoptosis there was no statistical significance difference between these percentages. • In mild asthma group: The apoptosis percentage in Basal line, EPR, and LPR were (30%), (20%), and (60%) respectively. Although the LPR had the highest increase of apoptosis percentage the difference between these percentages was still short of statistical significance. • In moderate asthma group: No statistical significance between the apoptosis percentage in Basal line, EPR, and LPR were (40%), (30%), and (20%) respectively, although the LPR had the lowest apoptosis percentage. • No statistically significant difference of mast cell apoptosis in the bronchial mucosal biopsies between mild and moderate asthmatic patients in biopsies of baseline, EPR, and in LPR. Conclusion • Mast cells play an effective role in the inflammatory process in the bronchial asthma in both the EPR and LPR. • Mast cells degranulation in EPR and LPR may indicate that baseline hyperresponsiveness is sustained by ongoing mast cells degranulation. • Mast cells apoptosis tend to be lower in EPR than in basal line and EPR. This may be due to presence of many stimuli, leading to increase number and survival of mast cells in bronchial mucosa. • In mild asthma, the apparent increase in mast cell apoptosis in LPR, may signifies a possible mechanism to down regulate the inflammatory reaction and termination of asthmatic attack. • In moderate asthma, the apparent decrease in mast cell apoptosis in LPR, may indicates that persistence of inflammatory reaction may be related to decreased mast cell apoptosis. • In LPR The decreased apoptosis percentage in moderate compared to mild asthma may signifies a possible correlation between the severity of asthma and mast cell apoptosis. • RECOMMONDATIONS: We recommend for; • Further studies for mast cells apoptosis as regard proapoptotic and antiapoptotic mediators. • Development of new drugs inducing mast cells apoptosis as a future therapy for asthma.