Eosinophils and Asthma

Abstract

Bousquet et al. (Oct. 11 issue)¹ and others2 ^{2 3 4 5} report that there is a general association between numbers of eosinophils and the severity of asthma. Unfortunately, the controls for their bronchial-biopsy data1 may not have been appropriate, since material obtained post mortem cannot reasonably be compared with fresh biopsy specimens obtained on bronchoscopy. The authors imply that with normal volunteers bronchoalveolar lavage is acceptable, but bronchial biopsy is not, even though the ethical issues have been clearly addressed in published reports of studies in which this procedure was performed in normal subjects.^{5 6 7} By what logic is it ethical to have patients with asthma who have forced expiratory volume in one second (FEV1) that is only 50 percent of the predicted value and who are not protected by corticosteroids or other antiasthma drugs undergo a bronchial biopsy and bronchoalveolar lavage, but unethical to obtain specimens by biopsy of normal volunteers with use of the fiberoptic bronchoscope and thus allow a study to be properly controlled and interpreted?