HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (44) Citing Articles via Google Scholar Google Scholar Articles by Bumbacea, D. Articles by Chung, K.F. Search for Related Content PubMed PubMed Citation Articles by Bumbacea, D. Articles by Chung, K.F.

Parameters associated with persistent airflow obstruction in chronic severe asthma

¹ Clinica de Pneumologie, Institutul National de Pneumologie "Marius Nasta", Universitatea de Medicina si Farmacie, Carol Davila, Bucharest, Romania. ² Asthma and Allergy Research Group, Royal Brompton and Harefield NHS Trust, and National Heart and Lung Institute, Imperial College, London, UK

CORRESPONDENCE: K.F. Chung, National Heart and Lung Institute, Imperial College School ofMedicine, Dovehouse Street, London SW36LY, UK. Fax: 44 2073518126. E-mail: f.chung@imperial.ac.uk

Keywords: Airway remodelling, airway thickening, eosinophils, severe asthma

Received: July 7, 2003
Accepted March 15, 2004

This work was supported by the Royal Brompton and Harefield NHS Trust, and European Respiratory Society Research Fellowships to D. Bumbacea and L. Nguyen.

The significance of severe airflow obstruction in severe asthma is unclear. The current study determined whether severe airflow obstruction is related to inflammatory or structural changes in the airways.

Patients with severe asthma from a tertiary referral clinic were divided into two groups according to their postbronchodilator forced expiratory volume in one second (FEV₁): severe persistent airflow limitation (FEV₁ <50% predicted; group S; n=37) and no obstruction (FEV₁ >80% pred; group N; n=29). Smoking history, atopic status, lung function tests, exhaled NO, blood eosinophil count, quality of life scores using St George's Respiratory Questionnaire and high resolution computed tomography (HRCT) of the lungs were assessed.

Patients from group S were older and had longer disease duration. There was no difference in smoking history, atopic status, hospital admissions, quality of life scores and amount of treatment with inhaled or oral corticosteroids. Exhaled NO and peripheral blood eosinophils were higher in group S (21.0±2.4 versus 12.8±2.3 ppb; 0.41±0.06 versus 0.15±0.03x10⁹cells·L^–1, respectively). HRCT scores for bronchial wall thickening and dilatation were higher in group S with no differences in air trapping. Peripheral blood eosinophilia and bronchial wall thickening on HRCT scan were the only parameters significantly and independently associated with persistent airflow obstruction.

Patients with severe asthma and irreversible airflow obstruction had longer disease duration, a greater inflammatory process and more high resolution computed tomography airway abnormalities suggestive of airway remodelling, despite being on similar treatments and experiencing equivalent impairment in quality of life.

This article has been cited by other articles:

				S. G. Royce, Y. R. Miao, M. Lee, C. S. Samuel, G. W. Tregear, and M. L. K. Tang Relaxin Reverses Airway Remodeling and Airway Dysfunction in Allergic Airways Disease Endocrinology, June 1, 2009; 150(6): 2692 - 2699. [Abstract] [Full Text] [PDF]

				J. D. Campbell, L. Borish, T. Haselkorn, L. Rasouliyan, J. H. Lee, S. E. Wenzel, S. D. Sullivan, and on behalf of the TENOR Study Group The response to combination therapy treatment regimens in severe/difficult-to-treat asthma Eur. Respir. J., November 1, 2008; 32(5): 1237 - 1242. [Abstract] [Full Text] [PDF]

				I. H. van Veen, A. ten Brinke, P. J. Sterk, J. K. Sont, S. A. Gauw, K. F. Rabe, and E. H. Bel Exhaled nitric oxide predicts lung function decline in difficult-to-treat asthma Eur. Respir. J., August 1, 2008; 32(2): 344 - 349. [Abstract] [Full Text] [PDF]

				R. L. Sorkness, E. R. Bleecker, W. W. Busse, W. J. Calhoun, M. Castro, K. F. Chung, D. Curran-Everett, S. C. Erzurum, B. M. Gaston, E. Israel, et al. Lung function in adults with stable but severe asthma: air trapping and incomplete reversal of obstruction with bronchodilation J Appl Physiol, February 1, 2008; 104(2): 394 - 403. [Abstract] [Full Text] [PDF]

				J. H. Lee, T. Haselkorn, L. Borish, L. Rasouliyan, B. E. Chipps, and S. E. Wenzel Risk Factors Associated With Persistent Airflow Limitation in Severe or Difficult-to-Treat Asthma: Insights From the TENOR Study Chest, December 1, 2007; 132(6): 1882 - 1889. [Abstract] [Full Text] [PDF]

				M. R. Sears Lung function decline in asthma Eur. Respir. J., September 1, 2007; 30(3): 411 - 413. [Full Text] [PDF]

				T. R. Bai, J. M. Vonk, D. S. Postma, and H. M. Boezen Severe exacerbations predict excess lung function decline in asthma Eur. Respir. J., September 1, 2007; 30(3): 452 - 456. [Abstract] [Full Text] [PDF]

				A. L. James and S. Wenzel Clinical relevance of airway remodelling in airway diseases Eur. Respir. J., July 1, 2007; 30(1): 134 - 155. [Abstract] [Full Text] [PDF]

				S. Wenzel Severe Asthma in Adults Am. J. Respir. Crit. Care Med., July 15, 2005; 172(2): 149 - 160. [Abstract] [Full Text] [PDF]

				M. Gaga Fixed obstruction in severe asthma: not just a matter of time Eur. Respir. J., July 1, 2004; 24(1): 8 - 10. [Full Text] [PDF]