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Martínez-García MA, Olveira C, Girón R, García-Clemente M, Máiz L, Sibila O, Golpe R, Rodríguez-Hermosa JL, Barreiro E, Méndez R, Prados C, Rodríguez-López J, Oscullo G, de la Rosa D. Reliability of blood eosinophil count in steady-state bronchiectasis. Pulmonology 2024:S2531-0437(23)00204-0. [PMID: 38182470 DOI: 10.1016/j.pulmoe.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 10/14/2023] [Accepted: 11/21/2023] [Indexed: 01/07/2024] Open
Abstract
RATIONALE The baseline value of eosinophils in peripheral blood (BEC) has been associated with different degrees of severity, prognosis and response to treatment in patients with bronchiectasis. It is not known, however, if this basal value remains constant over time. OBJECTIVES The aim of this study was to assess whether the BEC remains stable in the long term in patients with bronchiectasis. METHODS AND MEASUREMENTS Patients from the RIBRON registry of bronchiectasis diagnosed by computed tomography with at least 2 BEC measurements one year apart were included in the study. Patients with asthma and those taking anti-eosinophilic drugs were excluded. Reliability was assessed using the intra-class correlation coefficient (ICC). A patient with a BEC of at least 300 cells/uL or less than 100 cells/uL was considered eosinophilic or eosinopenic, respectively. Group changes over time were also calculated. MAIN RESULTS Seven hundred and thirteen patients were finally included, with a mean age of 66.5 (13.2) years (65.8 % women). A total of 2701 BEC measurements were performed, with a median number of measurements per patient of 4 (IQR: 2-5) separated by a median of 12.1 (IQR: 10.5-14.3) months between two consecutive measurements. The ICC was good (>0.75) when calculated between two consecutive measurements (approximately one year apart) but had dropped significantly by the time of the next annual measurements. Similarly, the change from an eosinophilic or eosinopenic patient to a non-eosinophilic or non-eosinopenic patient, respectively, was less than 30 % during the first year with respect to the baseline value but was close to 50 % in later measurements. CONCLUSIONS Given the significant changes observed in the baseline value of the BEC over time, its monitoring is necessary in patients with bronchiectasis in order to more reliably assess its usefulness.
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Affiliation(s)
- M A Martínez-García
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; CIBERES de Enfermedades Respiratorias. ISCIII. Madrid. Spain.
| | - C Olveira
- Servicio de Neumología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA)/Universidad de Málaga, Málaga, Spain
| | - R Girón
- Servicio de Neumología, Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain
| | - M García-Clemente
- Servicio de Neumología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - L Máiz
- Servicio de Neumología, Hospital Ramón y Cajal, Madrid, Spain
| | - O Sibila
- Servicio de Neumología, Hospital Clínico, Barcelona, Spain
| | - R Golpe
- Servicio de Neumología, Hospital Lucus Augusti, Lugo, Spain
| | | | - E Barreiro
- Servicio de Neumología, Hospital del Mar-IMIM, UPF, CIBERES, Barcelona, Spain; CIBERES de Enfermedades Respiratorias. ISCIII. Madrid. Spain
| | - Raúl Méndez
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; CIBERES de Enfermedades Respiratorias. ISCIII. Madrid. Spain
| | - C Prados
- Servicio de Neumología, Hospital La Paz, Madrid, Spain
| | - J Rodríguez-López
- Servicio de Neumología, Hospital San Agustín, Avilés, Asturias, Spain
| | - G Oscullo
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - D de la Rosa
- Servicio de Neumología, Hospital Santa Creu i Sant Pau, Barcelona, Spain
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Cazzola M, Matera MG, Martínez-García MÁ. Dual Broncodilator and Triple Therapy in Bronchiectasis. Clinical Trials are Urgently Needed. Arch Bronconeumol 2023; 59:787-788. [PMID: 37532648 DOI: 10.1016/j.arbres.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Affiliation(s)
- Mario Cazzola
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome 'Tor Vergata', Rome, Italy.
| | - Maria Gabriella Matera
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Miguel Ángel Martínez-García
- Respiratory Department, Polytechnic and University La Fe Hospital, Valencia, Spain; CIBERES de Enfermedades Respiratorias, Madrid, Spain
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3
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Martínez-García MÁ, Oscullo G, Gomez-Olivas JD. Peripheral cellular biomarkers in bronchiectasis. Respir Med Res 2023; 84:101063. [PMID: 38029651 DOI: 10.1016/j.resmer.2023.101063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/29/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Miguel Ángel Martínez-García
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, España; CIBERES de Enfermedades Respiratorias, ISCIII, Madrid, Spain.
| | - Grace Oscullo
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, España
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Tiotiu A, Martinez-Garcia MA, Mendez-Brea P, Roibas-Veiga I, Gonzalez-Barcala FJ. Does asthma-bronchiectasis overlap syndrome (ABOS) really exist? J Asthma 2023; 60:1935-1941. [PMID: 37071539 DOI: 10.1080/02770903.2023.2203743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 03/28/2023] [Accepted: 04/12/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE To analyze the relationship between asthma and bronchiectasis, as well as the necessary conditions that this connection must meet for this group of patients to be considered a special phenotype. DATA SOURCES We performed a PubMed search using the MeSH terms "asthma" and "bronchiectasis." The literature research was limited to clinical trials, meta-analyses, randomized controlled trials, cohort studies, and systematic reviews, involving adult patients, published until November 30th, 2022. STUDY SELECTIONS Selected papers were initially evaluated by the Authors, to assess their eligibility in contributing to the statements. RESULTS The prevalence of bronchiectasis is higher than expected in patients with asthma, particularly in those with more severe disease, and in some patients, between 1.4% and 7% of them, asthma alone could be the cause of bronchiectasis. Both diseases share etiopathogenic mechanisms, such as neutrophilic and eosinophilic inflammation, altered airway microbiota, mucus hypersecretion, allergen sensitization, immune dysfunction, altered microRNA, dysfunctional neutrophilic activity, and variants of the HLA system. Besides that, they also share comorbidities, such as gastroesophageal reflux disease and psychiatric illnesses. The clinical presentation of asthma is very similar to patients with bronchiectasis, which could cause mistakes with diagnoses and delays in being prescribed the correct treatment. The coexistence of asthma and bronchiectasis also poses difficulties for the therapeutic focus. CONCLUSIONS The evidence available seems to support that the asthma-bronchiectasis phenotype really exists although longitudinal studies which consistently demonstrate that asthma is the cause of bronchiectasis are still lacking.
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Affiliation(s)
- Angelica Tiotiu
- Department of Pulmonology, University Hospital of Nancy, Nancy, France
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, Nancy, France
| | - Miguel-Angel Martinez-Garcia
- Respiratory Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Paula Mendez-Brea
- Allergy Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Iria Roibas-Veiga
- Allergy Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Francisco-Javier Gonzalez-Barcala
- Centro de Investigación Biomédica en Red (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Traslational Research In Airway Diseases (TRIAD)-Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
- CIBER of Respiratory Diseases-CIBERES, Madrid, Spain
- Respiratory Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
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de la Rosa-Carrillo D, Máiz-Carro L, Martínez-García MÁ. What Have We Learned About Bronchiectasis From RIBRON (Spanish Bronchiectasis Registry)? Arch Bronconeumol 2023; 59:625-626. [PMID: 37516559 DOI: 10.1016/j.arbres.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 07/31/2023]
Affiliation(s)
| | - Luis Máiz-Carro
- Servicio de Neumologia, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Miguel Ángel Martínez-García
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; CIBERES de Enfermedades Respiratorias, ISCIII, Madrid, Spain
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Martínez-García MÁ, Oscullo G, Gómez-Olivas JD, Olveira C, Girón R, García-Clemente M, Máiz L, Sibila O, Golpe R, Rodríguez-Hermosa JL, Barreiro E, Méndez R, Prados C, Rodríguez-López J, de la Rosa D. Bronchiectasis: Changes in the Characterization of Patients During 20 Years of Follow-up. Data from the Spanish Bronchiectasis Registries. Arch Bronconeumol 2023; 59:688-690. [PMID: 37563019 DOI: 10.1016/j.arbres.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/12/2023]
Affiliation(s)
- Miguel Ángel Martínez-García
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; CIBERES de Enfermedades Respiratorias, ISCIII, Madrid, Spain.
| | - Grace Oscullo
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Casilda Olveira
- Servicio de Neumología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA)/Universidad de Málaga, Málaga, Spain
| | - Rosa Girón
- Servicio de Neumología, Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain
| | - Marta García-Clemente
- Servicio de Neumología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Luis Máiz
- Servicio de Neumología, Hospital Ramón y Cajal, Madrid, Spain
| | - Oriol Sibila
- Servicio de Neumología, Hospital Clínico, Barcelona, Spain
| | - Rafael Golpe
- Servicio de Neumología, Hospital Lucus Augusti, Lugo, Spain
| | | | - Esther Barreiro
- Servicio de Neumología, Hospital del Mar-IMIM, UPF, CIBERES, Barcelona, Spain; CIBERES de Enfermedades Respiratorias, ISCIII, Madrid, Spain
| | - Raúl Méndez
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; CIBERES de Enfermedades Respiratorias, ISCIII, Madrid, Spain
| | | | | | - David de la Rosa
- Servicio de Neumología, Hospital Santa Creu i Sant Pau, Barcelona, Spain
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Martínez-García MÁ, Méndez R, Olveira C, Girón R, García-Clemente M, Máiz L, Sibila O, Golpe R, Rodríguez-Hermosa JL, Barreiro E, Prados C, Rodríguez-López J, Oscullo G, Labarca G, de la Rosa D. The U-Shaped Relationship Between Eosinophil Count and Bronchiectasis Severity: The Effect of Inhaled Corticosteroids. Chest 2023; 164:606-613. [PMID: 37088355 DOI: 10.1016/j.chest.2023.04.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/10/2023] [Accepted: 04/14/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Although a proven relationship exists between the blood eosinophil count (BEC) and the severity of both asthma and COPD, its relationship with bronchiectasis has not been well established. The objective of this study was to analyze the relationship between BEC and the number and severity of exacerbations, and patients' responses to inhaled corticosteroid (IC) treatment in bronchiectasis RESEARCH QUESTION: Does an association exist among BEC, the number of exacerbations and severity of bronchiectasis, and IC treatment? STUDY DESIGN AND METHODS This was a multicenter (43 centers) prospective observational study derived from the Spanish Bronchiectasis Registry. Patients with proven bronchiectasis and a known BEC were included, whereas those with asthma or antieosinophilic treatments were excluded. Patients were divided into four groups according to the BEC at the time of inclusion in the study in a steady-state situation: (1) eosinopenic bronchiectasis (< 50 eosinophils/μL), (2) low number of eosinophils (51-100/μL), (3) normal number of eosinophils (101-300/μL), and (4) eosinophilic bronchiectasis (> 300 eosinophils/μL). RESULTS Nine hundred twenty-eight patients finally were included: 123 patients (13.3%) with < 50 eosinophils/μL (eosinopenic group), 164 patients (17.7%) with 50-100 eosinophils/μL, 488 patients (52.6%) with 101-300 eosinophils/μL, and 153 patients (16.5%) with > 300 eosinophils/μL (eosinophilic group). BEC showed a significant U-shaped relationship with severity, exacerbations, lung function, microbiologic profile, and IC treatment (these being higher in the eosinopenic group compared with the eosinophilic group). IC treatment significantly decreased the number and severity of exacerbations only in the group of bronchiectasis patients with > 300 eosinophils/μL. INTERPRETATION A significant U-shaped relationship was found between BEC and severity and exacerbations in bronchiectasis that was more pronounced in the eosinopenic group. IC treatment decreased the number and severity of exacerbations only in the eosinophilic group.
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Affiliation(s)
- Miguel Ángel Martínez-García
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; CIBERES de Enfermedades Respiratorias, ISCIII, Madrid, Spain.
| | - Raúl Méndez
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; CIBERES de Enfermedades Respiratorias, ISCIII, Madrid, Spain
| | - Casilda Olveira
- Servicio de Neumología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA)/Universidad de Málaga, Málaga, Spain
| | - Rosa Girón
- Servicio de Neumología, Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain
| | | | - Luis Máiz
- Servicio de Neumología, Hospital Ramón y Cajal, Madrid, Spain
| | - Oriol Sibila
- Servicio de Neumología, Hospital Clínico, Barcelona, Spain
| | - Rafael Golpe
- Servicio de Neumología, Hospital Lucus Augusti, Lugo, Spain
| | | | - Esther Barreiro
- CIBERES de Enfermedades Respiratorias, ISCIII, Madrid, Spain; Servicio de Neumología, Hospital del Mar-IMIM, UPF, CIBERES, Barcelona, Spain
| | | | | | - Grace Oscullo
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Gonzalo Labarca
- Division of Sleep Medicine, Harvard Medical School, Boston, MA; Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepción, Concepción, Chile
| | - David de la Rosa
- Servicio de Neumología, Hospital Santa Creu i Sant Pau, Barcelona, Spain
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Barbosa M, Chalmers JD. Bronchiectasis. Presse Med 2023; 52:104174. [PMID: 37778637 DOI: 10.1016/j.lpm.2023.104174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/03/2023] Open
Abstract
Bronchiectasis is a final common pathway of a wide variety of underlying conditions including infectious, autoimmune, allergic, genetic and inflammatory conditions. Patients experience a chronic disease with variable clinical symptoms and course, but most experience cough, sputum production and recurrent exacerbations. Symptoms of bronchiectasis lead to poor quality of life and exacerbations are the major driver of morbidity and mortality. Patients are often chronically infected with bacteria with the most common being Pseudomonas aeruginosa and Haemophilus influenzae. Treatment of bronchiectasis includes standardised testing to identify the underlying cause with targeted treatment if immune deficiency, allergic bronchopulmonary aspergillosis or non-tuberculous mycobacterial infection, for example, are identified. Airway clearance is the mainstay of therapy for patients with symptoms of cough and sputum production. Frequently exacerbating patients may benefit from long term antibiotic or mucoactive therapies. Bronchiectasis is a heterogeneous disease and increasingly precision medicine approaches are advocated to target treatments most appropriately and to limit the emergence of antimicrobial resistance.
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Affiliation(s)
- Miguel Barbosa
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK
| | - James D Chalmers
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK.
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Solarat B, Perea L, Faner R, de La Rosa D, Martínez-García MÁ, Sibila O. Pathophysiology of Chronic Bronchial Infection in Bronchiectasis. Arch Bronconeumol 2023; 59:101-108. [PMID: 36180278 DOI: 10.1016/j.arbres.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 02/07/2023]
Abstract
Bronchiectasis is a complex and heterogeneous disease. Its pathophysiology is poorly understood, but chronic bronchial infection plays an important role in its natural history, and is associated with poor quality of life, more exacerbations and increased mortality. Pseudomonas aeruginosa, Haemophilus influenzae and Staphylococcus aureus are the most common bacteria related to chronic bronchial infection. Non-tuberculous mycobacteria, fungi and respiratory viruses are also present during clinical stability, and may increase the risk of acute exacerbation. Chronic inflammation is present in bronchiectasis, especially neutrophilic inflammation. However, macrophages and eosinophils also play a key role in the disease. Finally, airway epithelium has innate mechanisms such as mucociliary clearance and antibacterial molecules like mucins and antimicrobial peptides that protect the airways from pathogens. This review addresses how the persistence of microorganisms in the airways and the imbalance of the immune system contribute to the development of chronic bronchial infection in bronchiectasis.
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Affiliation(s)
- Belén Solarat
- Respiratory Department, Hospital Clínic, IDIBAPS, CIBERES, C. de Villaroel, 170, 08036 Barcelona, Spain
| | - Lidia Perea
- Respiratory Department, Hospital Clínic, IDIBAPS, CIBERES, C. de Villaroel, 170, 08036 Barcelona, Spain
| | - Rosa Faner
- Respiratory Department, Hospital Clínic, IDIBAPS, CIBERES, C. de Villaroel, 170, 08036 Barcelona, Spain
| | - David de La Rosa
- Respiratory Department, Hospital Sant Pau, C. Sant Quintí, 89, 08041 Barcelona, Spain
| | - Miguel Ángel Martínez-García
- Respiratory Department, Hospital La Fe, CIBERES, Avinguda de Fernando Abril Martorell, 106, 46026 València, Spain
| | - Oriol Sibila
- Respiratory Department, Hospital Clínic, IDIBAPS, CIBERES, C. de Villaroel, 170, 08036 Barcelona, Spain.
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Peripheral Neutrophil-to-Lymphocyte Ratio in Bronchiectasis: A Marker of Disease Severity. Biomolecules 2022; 12:biom12101399. [PMID: 36291608 PMCID: PMC9599714 DOI: 10.3390/biom12101399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/22/2022] [Accepted: 09/28/2022] [Indexed: 11/17/2022] Open
Abstract
Most patients with bronchiectasis have a predominantly neutrophilic inflammatory profile, although other cells such as lymphocytes (as controllers of bronchial inflammation) and eosinophils also play a significant pathophysiological role. Easy-to-interpret blood biomarkers with a discriminative capacity for severity or prognosis are needed. The objective of this study was to assess whether the peripheral neutrophil-to-lymphocyte ratio (NLR) is associated with different outcomes of severity in bronchiectasis. A total of 1369 patients with bronchiectasis from the Spanish Registry of Bronchiectasis were included. To compare groups, the sample was divided into increasing quartiles of NLR ratio. Correlations between quantitative variables were established using Pearson's P test. A simple linear regression (with the value of exacerbations as a quantitative variable) was used to determine the independent relationship between the number and severity of exacerbations and the NLR ratio. The area under the curve (AUC)-ROC was used to determine the predictive capacity of the NLR for severe bronchiectasis, according to the different multidimensional scores. Mean age: 69 (15) years (66.3% of women). The mean NLR was 2.92 (2.03). A higher NLR was associated with more severe bronchiectasis (with an especially significant discriminative power for severe forms) according to the commonly used scores (FACED, E-FACED and BSI), as well as with poorer quality of life (SGRQ), more comorbidities (Charlson index), infection by pathogenic microorganisms, and greater application of treatment. Furthermore, the NLR correlated better with severity scores than other parameters of systemic inflammation. Finally, it was an independent predictor of the incident number and severity of exacerbations. In conclusion, the NLR is an inexpensive and easy-to-measure marker of systemic inflammation for determining severity and predicting exacerbations (especially the most severe) in patients with bronchiectasis.
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Bekki A, Beauperthuy T, Martínez-García MÁ. Traction bronchiectasis: is it as benign as we think? J Bras Pneumol 2022; 48:e20220220. [PMID: 35894416 PMCID: PMC9496464 DOI: 10.36416/1806-3756/e20220220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- Amina Bekki
- . Departamento de Neumología. Hospital Universitario y Politécnico La Fe, Valencia, España
| | - Thais Beauperthuy
- . Departamento de Neumología. Hospital Universitario y Politécnico La Fe, Valencia, España
| | - Miguel Ángel Martínez-García
- . Departamento de Neumología. Hospital Universitario y Politécnico La Fe, Valencia, España
- . Centro de Investigación Biomédica En Red de Enfermedades Respiratorias - CIBERES - Instituto de Salud Carlos III, Madrid, España
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13
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Asthma, bronchiectasis, and chronic obstructive pulmonary disease: the Bermuda Triangle of the airways. Chin Med J (Engl) 2022; 135:1390-1393. [PMID: 35869863 PMCID: PMC9481445 DOI: 10.1097/cm9.0000000000002225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Impact of Chronic Bronchial Infection by Staphylococcus aureus on Bronchiectasis. J Clin Med 2022; 11:jcm11143960. [PMID: 35887723 PMCID: PMC9319377 DOI: 10.3390/jcm11143960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of the study was to analyze the factors associated with chronic bronchial infection (CBI) due to methicillin-susceptible Staphylococcus aureus (SA) and assess the clinical impact on severity, exacerbations, hospitalizations, and loss of lung function compared to patients with no isolation of PPMs in a large longitudinal series of patients from the Spanish bronchiectasis registry (RIBRON). Material and methods: A prospective, longitudinal, multicenter study was conducted with patients included in the RIBRON registry between January 2015 and October 2020. The inclusion criteria were an age of 18 years or older and an initial diagnosis of bronchiectasis. Patients recorded in the registry had a situation of clinical stability in the absence of an exacerbation in the four weeks before their inclusion. All patients were encouraged to provide a sputum sample at each visit for microbiological culture. Annual pulmonary function tests were performed according to the national spirometry guidelines. Results: A total of 426 patients were ultimately included in the study: 77 patients (18%) with CBI due to SA and 349 (82%) who did not present any isolation of PPMs in sputum. The mean age was 66.9 years (16.2), and patients 297 (69.7%) were female, with an average BMI of 25.1 (4.7) kg/m2 and an average Charlson index of 1.74 (1.33). The mean baseline value of FEV1 2 L was 0.76, with a mean FEV1% of 78.8% (23.1). One hundred and seventy-two patients (40.4%) had airflow obstruction with FEV1/FVC < 0.7. The mean predictive FACED score was 1.62 (1.41), with a mean value of 2.62 (2.07) for the EFACED score and 7.3 (4.5) for the BSI score. Patients with CBI caused by SA were younger (p < 0.0001), and they had a lower BMI (p = 0.024) and more exacerbations in the previous year (p = 0.019), as well as in the first, second, and third years of follow-up (p = 0.020, p = 0.001, and p = 0.018, respectively). As regards lung function, patients with CBI due to SA had lower levels of FEV1% at the time of inclusion in the registry (p = 0.021), and they presented more frequently with bronchial obstruction (p = 0.042). A lower age (OR: 0.97; 95% CI: 0.94−0.99; p < 0.001), lower FEV1 value% (OR: 0.98; 95% CI: 0.97−0.99; p = 0.035), higher number of affected lobes (OR: 1.53; 95% CI: 1.2−1.95; p < 0.001), and the presence of two or more exacerbations in the previous year (OR: 2.33; 95% CI: 1.15−4.69; p = 0.018) were observed as independent factors associated with CBI due to SA. The reduction in FEv1% in all patients included in the study was −0.31%/year (95% CI: −0.7; −0.07) (p = 0.110). When the reduction in FEv1% is analyzed in the group of patients with CBI due to SA and the group without pathogens, we observed that the reduction in FEV1% was −1.19% (95% CI: −2.09, −0.69) (p < 0.001) in the first group and −0.02% (95% CI: −0.07, −0.01) (p = 0.918) in the second group. According to a linear regression model (mixed effects) applied to determine which factors were associated with a more pronounced reduction in FEv1% in the overall group (including those with CBI due to SA and those with no PPM isolation), age (p = 0.0019), use of inhaled corticosteroids (p = 0.004), presence of CBI due to SA (p = 0.007), female gender (p < 0.001), and the initial value of FEV1 (p < 0.001) were significantly related. Conclusions: Patients with non-CF bronchiectasis with CBI due to SA were younger, with lower FEV1% values, more significant extension of bronchiectasis, and a higher number of exacerbations of mild to moderate symptoms than those with no PPM isolation in respiratory secretions. The reduction in FEV1% was −1.19% (95% CI: −2.09, −0.69) (p < 0.001) in patients with CBI caused by SA.
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Martinez-Garcia MA, Sierra-Párraga JM, Quintana E, López-Campos JL. CFTR dysfunction and targeted therapies: A vision from non-cystic fibrosis bronchiectasis and COPD. J Cyst Fibros 2022; 21:741-744. [PMID: 35551858 DOI: 10.1016/j.jcf.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 04/24/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Miguel Angel Martinez-Garcia
- Pneumology Department, Hospital Universitario y Politécnico la Fe de Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos III, Madrid, Spain.
| | - Jesús María Sierra-Párraga
- Pepartment of regeneration an cell therapy. Andalusian molecular biology and regenerative medicine medicine center (CABIMER)-CSIC-US-UPO, Spain
| | - Esther Quintana
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS). Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Luis López-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS). Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos III, Madrid, Spain
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Martinez-Garcia MA, Bekki A, Beaupertuy T, Vergara AM. IS BRONCHIECTASIS ASSOCIATED WITH CARDIOVASCULAR DISEASE? Respir Med Res 2022; 81:100912. [DOI: 10.1016/j.resmer.2022.100912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/16/2022] [Indexed: 10/18/2022]
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Martinez-Garcia MÁ, Oscullo G, Garcia-Ortega A. Towards a new definition of non-cystic fibrosis bronchiectasis. J Bras Pneumol 2022; 48:e20220023. [PMID: 35137878 PMCID: PMC8836633 DOI: 10.36416/1806-3756/e20220023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Miguel Ángel Martinez-Garcia
- . Área Enfermedades Respiratorias. Hospital Universitari i Polytècnic La Fe, Valencia, España
- . Centro de Investigación Biomédica en Red - CIBERES - Enfermedades Respiratorias. Instituto de Salud Carlos III, Madrid, España
| | - Grace Oscullo
- . Área Enfermedades Respiratorias. Hospital Universitari i Polytècnic La Fe, Valencia, España
| | - Alberto Garcia-Ortega
- . Área Enfermedades Respiratorias. Hospital Universitari i Polytècnic La Fe, Valencia, España
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Beauperthuy T, Bekki A, Martínez-García MÁ. CHRONIC BRONCHIAL INFECTION IN STABLE COPD: AN UNDER-RECOGNIZED SITUATION THAT NEEDS ATENTION. Respir Med Res 2022; 81:100894. [DOI: 10.1016/j.resmer.2022.100894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
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Wang X, Villa C, Dobarganes Y, Olveira C, Girón R, García-Clemente M, Máiz L, Sibila O, Golpe R, Menéndez R, Rodríguez-López J, Prados C, Martinez-García MA, Rodriguez JL, de la Rosa D, Duran X, Garcia-Ojalvo J, Barreiro E. Systemic Inflammatory Biomarkers Define Specific Clusters in Patients with Bronchiectasis: A Large-Cohort Study. Biomedicines 2022; 10:225. [PMID: 35203435 PMCID: PMC8869143 DOI: 10.3390/biomedicines10020225] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 12/29/2022] Open
Abstract
Differential phenotypic characteristics using data mining approaches were defined in a large cohort of patients from the Spanish Online Bronchiectasis Registry (RIBRON). Three differential phenotypic clusters (hierarchical clustering, scikit-learn library for Python, and agglomerative methods) according to systemic biomarkers: neutrophil, eosinophil, and lymphocyte counts, C reactive protein, and hemoglobin were obtained in a patient large-cohort (n = 1092). Clusters #1-3 were named as mild, moderate, and severe on the basis of disease severity scores. Patients in cluster #3 were significantly more severe (FEV1, age, colonization, extension, dyspnea (FACED), exacerbation (EFACED), and bronchiectasis severity index (BSI) scores) than patients in clusters #1 and #2. Exacerbation and hospitalization numbers, Charlson index, and blood inflammatory markers were significantly greater in cluster #3 than in clusters #1 and #2. Chronic colonization by Pseudomonas aeruginosa and COPD prevalence were higher in cluster # 3 than in cluster #1. Airflow limitation and diffusion capacity were reduced in cluster #3 compared to clusters #1 and #2. Multivariate ordinal logistic regression analysis further confirmed these results. Similar results were obtained after excluding COPD patients. Clustering analysis offers a powerful tool to better characterize patients with bronchiectasis. These results have clinical implications in the management of the complexity and heterogeneity of bronchiectasis patients.
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Affiliation(s)
- Xuejie Wang
- Lung Cancer and Muscle Research Group, Pulmonology Department, Hospital del Mar-IMIM, Parc de Salut Mar, PRBB, C/Dr. Aiguader, 88, 08003 Barcelona, Spain;
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Carmen Villa
- Respiratory Department, Clínica Fuensanta, 28015 Madrid, Spain; (C.V.); (Y.D.)
| | - Yadira Dobarganes
- Respiratory Department, Clínica Fuensanta, 28015 Madrid, Spain; (C.V.); (Y.D.)
| | - Casilda Olveira
- Respiratory Department, Hospital Regional Universitario de Málaga, 29003 Málaga, Spain;
- Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29003 Málaga, Spain
| | - Rosa Girón
- Respiratory Department, Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, 28015 Madrid, Spain;
| | - Marta García-Clemente
- Respiratory Department, Hospital Universitario Central de Asturias, 33071 Oviedo, Spain;
| | - Luis Máiz
- Respiratory Department, Hospital Ramon y Cajal, 28015 Madrid, Spain;
| | - Oriol Sibila
- Respiratory Department, Hospital Clínic, 08035 Barcelona, Spain;
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28015 Madrid, Spain;
| | - Rafael Golpe
- Respiratory Department, Hospital Lucus Augusti, 27080 Lugo, Spain;
| | - Rosario Menéndez
- Respiratory Department, Hospital Universitario y Politécnico La Fe, 46003 Valencia, Spain;
| | | | | | - Miguel Angel Martinez-García
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28015 Madrid, Spain;
- Respiratory Department, Hospital Universitario y Politécnico La Fe, 46003 Valencia, Spain;
| | - Juan Luis Rodriguez
- Respiratory Department, Hospital Clínico San Carlos, 28015 Madrid, Spain;
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28015 Madrid, Spain
- Departamento de Medicina, Universidad Complutense de Madrid, 28015 Madrid, Spain
| | - David de la Rosa
- Respiratory Department, Hospital Santa Creu I Sant Pau, 08035 Barcelona, Spain;
| | - Xavier Duran
- Scientific and Technical Department, Hospital del Mar-IMIM, 08035 Barcelona, Spain;
| | - Jordi Garcia-Ojalvo
- Department of Health and Experimental Sciences (CEXS), Universitat Pompeu Fabra (UPF), 08035 Barcelona, Spain;
| | - Esther Barreiro
- Lung Cancer and Muscle Research Group, Pulmonology Department, Hospital del Mar-IMIM, Parc de Salut Mar, PRBB, C/Dr. Aiguader, 88, 08003 Barcelona, Spain;
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28015 Madrid, Spain;
- Department of Health and Experimental Sciences (CEXS), Universitat Pompeu Fabra (UPF), 08035 Barcelona, Spain;
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