Chest
Clinical Investigations: AsthmaMild Exacerbations and Eosinophilic Inflammation in Patients With Stable, Well-Controlled Asthma After 1 Year of Follow-up
Section snippets
Subjects
We recruited subjects aged 18 to 65 years with at least a 2-year history of asthma but who reported being asymptomatic with regular inhaled steroid treatment (defined as well-controlled asthma, as previously described8). The diagnosis of asthma and assessment of clinical and functional severity were based on the international consensus of 1992.9 All the subjects were classified as having moderate asthma (asthmatics with normal spirometry findings or mild airflow limitation who need regular
Subject Demographics and Enrollment
We identified 31 consecutive subjects (19 female and 12 male) with stable, well-controlled asthma. Six subjects were ex-smokers, and the remaining 25 subjects were lifelong nonsmokers. In the run-in period, 13 subjects had no symptoms and the remaining 18 subjects had very mild symptoms (mainly wheezing or coughing) and needed a mean of 0.75 puffs of bronchodilator per day. Baseline cough, wheeze, and bronchodilator use were occasional and mainly related to exercise. The median dose of inhaled
Discussion
Nearly half of the subjects with well-controlled asthma in our study (according to well-established criteria) had at least one mild exacerbation within 12 months of enrollment, with a cumulative estimated exacerbation rate of 49% and mean time to exacerbation of 175 days for those experiencing a mild exacerbation. In addition, those who showed signs of active eosinophilic inflammation (eosinophils or ECP) at the beginning also proved to have higher risk of exacerbation.
The aim of current
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2009, Respiratory MedicineCitation Excerpt :Our study further documents the benefits of pursuing a minimal dose of ICS to maintain the improvement obtained with a low dose of ICS in mild asthma. In these patients, the reduction of sputum eosinophils and their maintenance within the normal range may reduce the risks of clinical exacerbations3,57–61 and possibly the risk of airway remodelling.62 Regular maintenance treatment has been shown to be beneficial in patients with mild persistent asthma.25
Bronchial exudate of serum proteins during asthma attack
2005, Archivos de Bronconeumologia
Supported in part by a grant from the Sociedad Española de Neumología.