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Titolo:
Factors associated with persistent airflow limitation in severe asthma
Autore:
ten Brinke, A; Zwinderman, AH; Sterk, PJ; Rabe, KF; Bel, EH;
Indirizzi:
Leiden Univ, Med Ctr, Dept Pulm Dis, NL-2300 RC Leiden, Netherlands LeidenUniv Leiden Netherlands NL-2300 RC NL-2300 RC Leiden, Netherlands Leiden Univ, Dept Med Stat, NL-2300 RA Leiden, Netherlands Leiden Univ Leiden Netherlands NL-2300 RA NL-2300 RA Leiden, Netherlands
Titolo Testata:
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
fascicolo: 5, volume: 164, anno: 2001,
pagine: 744 - 748
SICI:
1073-449X(20010901)164:5<744:FAWPAL>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
AIR-FLOW OBSTRUCTION; LONG-TERM INFLAMMATION; LUNG-FUNCTION; BRONCHIAL-ASTHMA; FOLLOW-UP; PULMONARY-FUNCTION; NATURAL-HISTORY; RISK-FACTORS; DECLINE; ADULTS;
Keywords:
asthma; severity of illness index; airway obstruction; sputum; eosinophilia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
42
Recensione:
Indirizzi per estratti:
Indirizzo: ten Brinke, A Leiden Univ, Med Ctr, Dept Pulm Dis, C3-P,POB 9600, NL-2300 RC Leiden, Netherlands Leiden Univ C3-P,POB 9600 Leiden Netherlands NL-2300 RC nds
Citazione:
A. ten Brinke et al., "Factors associated with persistent airflow limitation in severe asthma", AM J R CRIT, 164(5), 2001, pp. 744-748

Abstract

Persistent airflow limitation can develop in nonsmoking patients with asthma. However, the prevalence and risk factors for airways obstruction with incomplete reversibility in asthma are unknown. We assessed the prevalence of persistent airflow limitation (defined as postbronchodilator FEV1 or FEV1/VC < 75% predicted) in 132 nonsmoking outpatients with severe asthma visiting chest physicians in general hospitals in The Netherlands. They had usedinhaled corticosteroids (greater than or equal to 1,600 mug/d) and/or daily oral prednisone and long-acting bronchodilators for > 1 yr. In addition, we examined whether persistent airways obstruction in these patients was associated with specific clinical characteristics (age at onset, smoking history, atopic status, bronchodilator reversibility, provocative concentrationof histamine causing a 20% decrease in FEV1 [PC(20)histamine]) or markers of inflammation (exhaled nitric oxide [NO], blood eosinophils, total IgE; and eosinophilia or neutrophilia in induced sputum). Multiple logistic regression analyses were used to calculate adjusted odds ratios (OR). Persistentairflow limitation was observed in 49% of the patients in the study, and apart from older age and longer asthma duration, was strongly associated with a sputum eosinophils percent greater than or equal to 2% (OR = 7.7; confidence interval [CI]: 2.4 to 25), PC(20)histamine less than or equal to 1.0 mg/ml (OR = 3.9; CI: 1.2 to 13), and adult onset (greater than or equal to 18 yr) of asthma (OR = 3.3; CI: 1.2 to 9). Only sputum eosinophilia appeared to be independently associated with persistent airflow limitation (OR = 8.9; CI: 1.3 to 59). In conclusion, persistent airflow limitation is common in adult patients with severe asthma, and is associated with adult onset ofthe disease, airway hyperresponsiveness, and most importantly, sputum eosinophilia. These findings suggest that eosinophilic airway inflammation contributes to persistent airflow limitation in severe asthma. Whether reduction of sputum eosinophils with more vigorous treatment leads to a better prognosis in severe asthma is still an open question.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 13:23:55