Figures
- Fig. 1.—
Percentage of positive skin-prick tests to common aeroallergens in asthmatic patients with well-controlled (┘) or severe (□) asthma. #: represents the total number of subjects in each group with at least one positive reaction. Local 1 and Local 2 indicate the two most frequent allergens specific to the geographical region. *: p<0.05.
- Fig. 2.—
Sputum differential cell count in subjects with severe asthma (┘; n=99) compared with subjects with well-controlled asthma (□; n=89). Data expressed as %±sem. There were no difference in total sputum cell counts between the groups (controlled asthma 4.6±0.5 million cells per gram versus 5.6±0.6 million cells per gram in the subjects with severe asthma). *: p<0.05.
Tables
- Table 1
Participating centres
City/country University Hospital/affiliations Investigators Athens, Greece University of Athens Sotiria Chest Hospital Evgenidio Hospital AstraZeneca M. Gaga, N. Papageorgiou C. Gratziou G. Yourgioti Barcelona, Spain Institut Municipal d'Investigació Mèdica Hospital del Mar Novartis Global Epidemiology J.M. Antó, E. Barreiro, C. Sanjuas J. Castellsague Ferrara, Italy Universita degli Studi di Ferrara Clinica di Malattie dell’Apparato Respiratorio L.M. Fabbri#, A. Papi, M. Romagnoli Ghent, Belgium University of Ghent Ghent University Hospital J.C. Kips, R.A. Pauwels Groningen, The Netherlands University of Groningen University Hospital, Groningen H.A.M. Kerstjens, D.S. Postma, W. Timens Hamburg, Germany University of Hamburg Krankenhaus Groβhansdorf N. Drews, F. Kanniess, H. Magnussen, K. Richter Heraklion, Greece University of Heraklion Heraklion University Hospital N.M. Siafakas, N. Tzanakis Leiden, The Netherlands Leiden University Leiden University Medical Centre Leyenburg Hospital E.H.D. Bel, K.F. Rabe A.C. Roldaan Montpellier, France University of Montpellier Hopital Arnaud de Villeneuve J. Bousquet, P. Chanez, I. Vachier Palermo, Italy Universita degli Studi di Palermo Ospedale V Cervello G. Bonsignore, F. Cibella, G. Cuttitta, G. Guerrera, A.M. Vignola Southampton, UK University of Southampton Southampton General Hospital B. Abraham, R. Djukanovic, S.T. Holgate, P.H. Howarth, S.L. Johnston¶, L. Watson Stockholm, Sweden Karolinska Institutet Karolinska Hospital B. Dahlén+, S-E. Dahlén, M. Kumlin, A. Roquet Utrecht, The Netherlands University of Utrecht (analytical centre) G. Folkerts, F.P. Nijkamp -
Current affiliations: #: University of Modena, Italy
-
¶: Imperial College, London, UK
-
+: Huddinge University Hospital, Stockholm, Sweden
-
- Table 2
Study subjects' demographic and clinical characteristics
Controlled asthma Severe asthma Controlled versus severe asthma Subjects n 158 163 Age yr 40.9±14.3 42.4±12.1 ns Sex ratio female:male 1.6:1 4.4:1 p<0.001 Height cm Male 175.3±8.4 172.2±7.6 ns Female 161.7±8.1 161.7±7.4 ns Weight kg Male 78.6±14.9 80.4±16.3 ns Female 66.5±11.4 70.9±15.5 p<0.05 BMI kg·m−2 Male 26.3±6.4 26.5±4.2 ns Female 25.6±4.9 27.2±6.0 p<0.05 Systolic BP mmHg Male 127.0±24.6 131.4±11.9 p<0.01 Female 123.1±20.1 130.2±19.7 p<0.01 Diastolic BP mmHg Male 79.6±10.7 83.1±7.0 p<0.001 Female 76.8±10.8 82.0±12.1 p<0.001 Heart frequency beats·min−1 Male 67.7±10.8 82.3±19.3 p<0.001 Female 73.9±9.2 82.7±14.6 p<0.001 Respiratory rate per min Male 15.4±3.6 16.7±3.5 ns Female 16.9±4.2 18.1±4.5 ns p<0.01¶ Dose of inhaled steroid# 666±285 1676±667 p<0.001 -
All data are expressed as mean±sd unless otherwise indicated
-
BMI: body mass index
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BP; blood pressure
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#: steroid expressed as beclomethasone equivalents
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¶: for males and females combined
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- Table 3
Sex ratio distribution among subjects with severe asthma from the different participating centres
Centre Severe asthma n Female n (%) Ratio female:male Montpellier 15 9 (60) 1.50 Groningen 8 6 (75) 3.00 Leiden 12 9 (75) 2.25 Palermo 17 13 (76) 3.25 Ghent 9 7 (78) 3.50 Ferrara 14 11 (79) 3.67 Grosshansdorf 10 8 (80) 4.00 Barcelona 8 7 (88) 7.00 Southampton 18 16 (89) 8.00 Stockholm 20 18 (90) 9.00 Athens 21 19 (90) 9.50 Heraklion 11 10 (91) 10.00 Total 163 133 (82) -
Mean odds ratio female versus male (95% CI): 2.69 (1.6–4.49)
-
Chi-squared p‐value 0.001
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- Table 4
Pulmonary function tests (per cent of predicted) and blood gases
Controlled asthma Severe asthma Controlled versus severe asthma Subjects n 130 133–153# FEV1 88.5±18.1 71.8±23.1 p<0.001 FEV1 post salbutamol 97.6±17.8 80.9±24.1 p<0.001 FVC 103.1±16.1 94.1±21.1 p<0.001 FEV1/FVC 89.7±12.8 79.9±16.6 p<0.001 TLC 104.1±13.4 104.4±15.2 ns RV/TLC 104.2±23.0 113.4±28.0 p<0.01 K CO 95.0±16.7 90.6±19.0 p<0.05 Pa,O2 kPa 12.0±1.6 11.2±1.9 p<0.001 Pa,CO2 kPa 5.1±0.5 4.9±0.5 p<0.01 pH 7.41±0.03 7.42±0.03 ns HCO3 mmol·L−1 24.8±2.4 24.3±2.4 ns Base excess mmol·L−1 0.7±2.3 0.4±2.2 ns -
Data presented as mean±sd
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FEV1: forced expiratory volume in one second
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FVC: forced vital capacity
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TLC: total lung capacity
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ns: not significant
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RV: residual volume
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KCO: carbon monoxide transfer coefficient
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Pa,O2: arterial oxygen tension
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Pa,CO2: carbon dioxide arterial tension
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#: Twenty subjects did not perform all spirometry measurements or blood gases
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- Table 5
Biomarkers of inflammation
Controlled asthma Severe asthma Controlled versus severe asthma Peripheral WBC Subjects n 130 162 ns Total count ×109·L−1 6.7±1.7 8.6±3.4 <0.05 Monocytes % 7.2±2.4 6.5±2.1 ns Neutrophils % 57.3±8.3 61.2±12.1 <0.05 Lymphocytes % 30.4±7.1 27.1±9.3 ns Eosinophils % 4.1±3.1 4.4±5.0 ns Basophils % 0.7±0.8 0.7±0.8 ns Urinary mediators Subjects n 136 153 LTE4 ng·mmol−1 creatinine 48±5.8 58±7.7# <0.05 EPX µg·mmol−1 creatinine 45±4.6 62±9.3# <0.05 Exhaled NO Subjects n 45 50 Geometric mean ppb# (95% CI) 9.2 (7.0–7.3) 9.8 (7.3–13.2) ns -
Data are presented as mean±sd unless otherwise indicated
-
WBC: white blood count
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LTE4: leukotriene E4: EPX: eosinophil protein X
-
NO: nitric oxide
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CI: confidence interval
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#: age and sex adjusted
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