Abstract
Introduction: There is disparity in prevalence and hospitalisations for asthma and COPD in Indigenous Australians. However, little is known about the pattern of airway inflammation and clinical severity. Our aim was to characterise the pattern of airway inflammation and relate this to disease severity and symptoms in Indigenous Australians and matched non-indigenous people with asthma and COPD.
Methods: Stable participants(n=94) with asthma or COPD underwent bronchoscopy and bronchoalveolar lavage (BL) for inflammatory cell count, lung function was assessed by spirometry, symptoms Asthma Control Questionnaire (ACQ)6 and COPD Assessment Test. Twenty-three participants identified as being of Aboriginal and/or Torres Strait Islander origin. Participants were age and disease matched in a ratio of 1:3 to non-Indigenous participants.
Results: Lung function, disease severity and dose of inhaled corticosteroids was similar. Current smoking was more common in Indigenous adults, 43% compared to 11% of non-Indigenous adults (p=0.009). Total scores ACQ6 and CAT scores were similar. Indigenous participants had higher scores for cough and sputum in the CAT (p=0.017) and were more likely to have a higher impact (CAT score ≥14, (85% to 25%, p=0.017). Indigenous participants with asthma rated their wheeze worse within the last week (2 to 1, respectively p=0.042). There was no difference in BL cell counts (Total cell count, eosinophils or neutrophils).
Conclusion: Indigenous adults with COPD and asthma demonstrate more severe symptoms suggesting, especially in the domains of cough and sputum. This may indicate a heightened risk. Neutrophilic and eosinophilic inflammatory patterns were similar between the groups.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA680.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021