CONTRIBUTION OF CD4+ T CELLS TO BRONCHIAL WALL INFLAMMATION IN ASTHMA

Authors

  • Cornelia AMALINEI Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
  • Adriana GRIGORAS Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
  • C. C. GRIGORAS Clinical Hospital of Pneumology Iasi

DOI:

https://doi.org/10.22551/

Abstract

Aim: Asthma is a chronic respiratory condition characterized by a complex interplay between different types of immune cells and morphological structures of the bronchial wall, which contributes to bronchial hyper-reactivity, mucus hypersecretion, and airway narrowing. Within the heterogeneous immunological profile of asthma, CD4+ T cells play an essential role in disease progression, bronchial wall remodeling, and response to treatment. The aim of this study was to evaluate the relationship between CD4+ T cells infiltration in bronchial wall and spirometry parameters in a group of asthmatic patients. Materials and methods: This study comprised 21 patients with a history of bronchial asthma, with different degrees of severity based on the latest Global Initiative for Asthma (GINA) classification. All patients underwent a fibro bronchoscopy examination accompanied by tissue biopsy for microscopical analysis. Results: The study comprised 21 asthmatic patients, with a female predominance (52.38%) and a mean patient age of 44.1±16.1 years. Microscopic examination revealed a progressive accumulation of inflammatory cells and CD4+ T cells within the bronchial wall, consistent with asthma severity, compared to healthy individuals. The statistical analysis showed an inverse correlation between FEV1 (forced expiratory volume in 1 second) (%) values and CD4 immunoexpression (r = -0.89, p < 0.001). Conclusions: The gradual accumulation of CD4+ T cells in bronchial wall is one the most significant pathological feature, which is predominantly observed in severe asthma and is associated with impaired lung function. 

Author Biographies

  • Cornelia AMALINEI, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania

    Institute of Forensic Medicine Iasi

  • Adriana GRIGORAS, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania

    Institute of Forensic Medicine Iasi

References

1. Reza MI, Ambhore NS. Inflammation in asthma: mechanistic insights and the role of biologics in therapeutic frontiers. Biomedicines 2025; 13: 1342.

2. Jeong J, Lee HK. The Role of CD4+ T cells and microbiota in the pathogenesis of asthma. Int J Mol Sci 2021; 22:11822.

3. Grigoras A, Grigoras CC, Giusca SE, et al. Remodeling of basement membrane in patients with asthma. Rom J Morphol Embryol 2016; 57: 115-119.

4. Grigoras A, Caruntu ID, Grigoras CC, et al. Relationship between immunohistochemical as-sessment of bronchial mucosa microvascularization and clinical stage in asthma. Rom J Morphol Embryol 2012; 53: 485-490.

5. Visca D, Ardesi, F, Zappa M, et al. Asthma and hypertension: The role of airway inflammation. Front Med 2024; 11: 1451625.

6. Bryant N, Muehling L. T-cell responses in asthma exacerbations. Ann Allergy Asthma Immunol 2022; 129: 709-718.

7. Olsthoorn S, van Krimpen A, Hendriks R, et al. Chronic inflammation in asthma: Looking beyond the Th2 Cell. Immunol Rev 2025; 330(1): e70010.

8. Global Initiative for Asthma. Global strategy for asthma management and prevention. 2025. Updated May 2025 https://ginasthma.org/world-asthma-day-2025/

9. Meyerholz D, Beck A. Principles and approaches for reproducible scoring of tissue stains in research. Lab Invest 2018; 98(7): 844-855.

10. Dey S, Lu W, Haug G, et al. Airway inflammatory changes in the lungs of patients with asth-ma‑COPD overlap (ACO): a bronchoscopy endobronchial biopsy study. Respir Res 2023; 24: 221.

11. Chen Y, Chen L, Xing C, et al. The risk of rheumatoid arthritis among patients with inflammatory bowel disease: a systematic review and meta-analysis. BMC Gastroenterol 2020; 20: 192.

12. Stanculet N, Grigoras A, Predescu O, et al. Operational scores in the diagnosis of chronic hepa-titis. A semi-quantitative assessment. Rom J Morphol Embryol 2012; 53: 81-87.

13. Man AM, Orăsan MS, Hoteiuc OA, et al. Inflammation and psoriasis: A comprehensive review. Int J Mol Sci 2023; 24(22): 16095.

14. Muehling L, Lawrence M, Woodfolk J. Pathogenic CD4+ T cells in patients with asthma. J Allergy Clin Immunol. 2017; 140(6): 1523-1540.

15. Georas SN, Guo J, Fanis U, Casolaro V. T-helper cell type-2 regulation in allergic disease. Eur Respir J 2005; 26: 1119-1137.

16. Herrera-De La Mata S, Ramirez-Suastegui C, Mistry H, et al. Cytotoxic CD4+ tissue-resident memory T cells are associated with asthma severity. Med 2023; 4(12): 875-897.e8.

17. Heffler E, Carpagnano GE, Favero E, et al. Fractional exhaled nitric oxide (FENO) in the man-agement of asthma: A position paper of the Italian Respiratory Society (SIP/IRS) and Italian So-ciety of Allery, Asthma and Clinical Immunology (SIAAIC) Multidiscip. Respir Med 2020; 15: 36.

18. Chin-See-Chong T, Kappen J, Palmer E, et al. Mechanisms and treatment of Type 2 high and low asthma endotypes. Clin Exp Allergy 2025; 55: 773-783.

19. Liu H, Li Z, Sun Y, et al. Type 2 inflammation accelerates CD4+ T-cell senescence in asthma. J Zhejiang Univ Sci B 2026; 27(2):149-163.

20. Akbari O, Faul J, Hoyte E, et al. CD4+ Invariant T-Cell–Receptor+ natural killer T cells in bronchial asthma. N Engl J Med 2006; 354: 1117-1129.

21. den Otter I, Willems L, van Schadewijk A, et al. Lung function decline in asthma patients with elevated bronchial CD8, CD4 and CD3 cells. Eur Respir J 2016; 48(2): 393-402.

22. Lu Y, Kared H, Tan SW, et al. Dynamics of helper CD4 T cells during acute and stable allergic asthma. Mucosal Immunol 2018; 11: 1640-1652.

23. Doi S, Murayama N, Inoue T, et al. CD4 T-lymphocyte activation is associated with peak expir-atory flow variability in childhood asthma. J Allergy Clin Immunol 1996; 97(4): 955-962.

Additional Files

Published

2026-09-28

Issue

Vol. 130 No. 3 (2026): The Medical-Surgical Journal

Section

BASIC SCIENCES

License

Copyright (c) 2026 The Medical-Surgical Journal

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

COPYRIGHT 
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.

COPYRIGHT TRANSFER FORM FOR 

REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /

THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI

We, the undersigned authors of the manuscript entitled

_____________________________________________________________________________________

_____________________________________________________________________________________

warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.

  1. we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
  2. the manuscript does not break the intellectual property rights of any other person.
  3. we have read the submitted version of the manuscript and we are fully responsible for the content.

Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):

  1. ______________________________/_________________________
  2. ______________________________/_________________________
  3. ______________________________/_________________________

N.B.  All the authors must sign this form