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Guida G, Bagnasco D, Carriero V, Bertolini F, Ricciardolo FLM, Nicola S, Brussino L, Nappi E, Paoletti G, Canonica GW, Heffler E. Critical evaluation of asthma biomarkers in clinical practice. Front Med (Lausanne) 2022; 9:969243. [PMID: 36300189 PMCID: PMC9588982 DOI: 10.3389/fmed.2022.969243] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
The advent of personalized medicine has revolutionized the whole approach to the management of asthma, representing the essential basis for future developments. The cornerstones of personalized medicine are the highest precision in diagnosis, individualized prediction of disease evolution, and patient-tailored treatment. To this aim, enormous efforts have been established to discover biomarkers able to predict patients' phenotypes according to clinical, functional, and bio-humoral traits. Biomarkers are objectively measured characteristics used as indicators of biological or pathogenic processes or clinical responses to specific therapeutic interventions. The diagnosis of type-2 asthma, prediction of response to type-2 targeted treatments, and evaluation of the risk of exacerbation and lung function impairment have been associated with biomarkers detectable either in peripheral blood or in airway samples. The surrogate nature of serum biomarkers, set up to be less invasive than sputum analysis or bronchial biopsies, has shown several limits concerning their clinical applicability. Routinely used biomarkers, like peripheral eosinophilia, total IgE, or exhaled nitric oxide, result, even when combined, to be not completely satisfactory in segregating different type-2 asthma phenotypes, particularly in the context of severe asthma where the choice among different biologics is compelling. Moreover, the type-2 low fraction of patients is not only an orphan of biological treatments but is at risk of being misdiagnosed due to the low negative predictive value of type-2 high biomarkers. Sputum inflammatory cell analysis, considered the highest specific biomarker in discriminating eosinophilic inflammation in asthma, and therefore elected as the gold standard in clinical trials and research models, demonstrated many limits in clinical applicability. Many factors may influence the measure of these biomarkers, such as corticosteroid intake, comorbidities, and environmental exposures or habits. Not least, biomarkers variability over time is a confounding factor leading to wrong clinical choices. In this narrative review, we try to explore many aspects concerning the role of routinely used biomarkers in asthma, applying a critical view over the "state of the art" and contemporarily offering an overview of the most recent evidence in this field.
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Affiliation(s)
- Giuseppe Guida
- Severe Asthma and Rare Lung Disease Unit, Department of Clinical and Biological Sciences, San Luigi Gonzaga University Hospital, University of Torino, Turin, Italy
| | - Diego Bagnasco
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, Department of Internal Medicine (DIMI), University of Genoa, Genoa, Italy
| | - Vitina Carriero
- Severe Asthma and Rare Lung Disease Unit, Department of Clinical and Biological Sciences, San Luigi Gonzaga University Hospital, University of Torino, Turin, Italy
| | - Francesca Bertolini
- Severe Asthma and Rare Lung Disease Unit, Department of Clinical and Biological Sciences, San Luigi Gonzaga University Hospital, University of Torino, Turin, Italy
| | - Fabio Luigi Massimo Ricciardolo
- Severe Asthma and Rare Lung Disease Unit, Department of Clinical and Biological Sciences, San Luigi Gonzaga University Hospital, University of Torino, Turin, Italy
| | - Stefania Nicola
- Allergy and Immunology, AO Mauriziano Hospital, University of Turin, Turin, Italy
| | - Luisa Brussino
- Allergy and Immunology, AO Mauriziano Hospital, University of Turin, Turin, Italy
| | - Emanuele Nappi
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giovanni Paoletti
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giorgio Walter Canonica
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Enrico Heffler
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Blais CM, Davis BE, Cockcroft DW. Diversity of methacholine dose-response curves among asymptomatic non-asthmatics. Respir Med 2017; 132:109-111. [PMID: 29229081 DOI: 10.1016/j.rmed.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 09/13/2017] [Accepted: 10/05/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Christianne M Blais
- University of Saskatchewan, College of Medicine, Department of Physiology, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Beth E Davis
- University of Saskatchewan, College of Medicine, Department of Physiology, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; University of Saskatchewan, College of Medicine, Department of Medicine, Division of Respirology, Critical Care and Sleep Medicine, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Donald W Cockcroft
- University of Saskatchewan, College of Medicine, Department of Physiology, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; University of Saskatchewan, College of Medicine, Department of Medicine, Division of Respirology, Critical Care and Sleep Medicine, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada.
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Mazan MR. Update on noninfectious inflammatory diseases of the lower airway. Vet Clin North Am Equine Pract 2015; 31:159-85. [PMID: 25770068 DOI: 10.1016/j.cveq.2014.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Inflammatory airway disease and recurrent airway obstruction are 2 nonseptic diseases of the equine respiratory system with a shared cause of exposure to particulate matter. They appear to occupy 2 ends of a spectrum of disease, but are differentiated by history, clinical signs, and response to treatment. Diagnosis can be made by sampling of respiratory fluids and lung function testing. Treatment consists of environmental modification and pharmacologic treatment with systemic or inhaled corticosteroids and bronchodilators.
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Affiliation(s)
- Melissa R Mazan
- Large Animal Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westborough Road, North Grafton, MA 01536, USA.
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Risse PA, Lavoie-Lamoureux A, Jo T, Tsuchiya K, Siddiqui S, Martin JG. Airway arginase expression and Nω-hydroxy-nor-arginine effect on methacholine-induced bronchoconstriction differentiate Lewis and Fischer rat strains. J Appl Physiol (1985) 2014; 116:621-7. [PMID: 24505101 DOI: 10.1152/japplphysiol.01241.2013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Innate airway hyperresponsiveness (AHR) is well modeled by two strains of rat, the hyperresponsive Fischer 344 rat and the normoresponsive Lewis rat. Arginase has been implicated in AHR associated with allergic asthma models. We addressed the role of arginase in innate AHR using the Fischer-Lewis model. In vivo arginase inhibition with N(ω)-hydroxy-nor-arginine (nor-NOHA) was evaluated on methacholine-induced bronchoconstriction in the Fischer and the Lewis rats. Arginase activity and mRNA expression were quantified in structural and resident cells of the proximal airway tree. The effect of nor-NOHA was evaluated on cultured tracheal smooth muscle proliferation. Fischer rats exhibited significantly greater changes in respiratory resistance and elastance in response to methacholine compared with Lewis rats. nor-NOHA reduced the methacholine-induced bronchoconstriction in the central airways of Lewis rats, while it did not change the innate AHR of Fischer rats. Lewis rats exhibited greater arginase activity in tracheal smooth muscle but a lower proliferation rate compared with Fischer rats. Smooth muscle proliferation was not affected by nor-NOHA in either strain of rats. The strain-specific arginase expression in the smooth muscle may contribute to the differences in sensitivity of the methacholine challenged airways of Lewis and Fischer rats to inhibition of arginase.
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Affiliation(s)
- Paul-André Risse
- Meakins Christie Laboratories, McGill University, Montreal, Quebec, Canada
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Boudewijn IM, Telenga ED, van der Wiel E, van der Molen T, Schiphof L, ten Hacken NHT, Postma DS, van den Berge M. Less small airway dysfunction in asymptomatic bronchial hyperresponsiveness than in asthma. Allergy 2013; 68:1419-26. [PMID: 24128343 DOI: 10.1111/all.12242] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bronchial hyperresponsiveness (BHR) can be present in subjects without any respiratory symptoms. Little is known about the role of the small airways in asymptomatic subjects with BHR. METHODS We investigated small airway function assessed by spirometry and impulse oscillometry, as well as Borg dyspnea scores at baseline and during a methacholine provocation test in 15 subjects with asymptomatic BHR, 15 asthma patients, and 15 healthy controls. RESULTS At baseline, small airway function (R5 -R20 and X5 ) was comparable between subjects with asymptomatic BHR and healthy controls, whereas asthma patients showed small airway dysfunction as reflected by higher R5 -R20 and lower X5 values. During methacholine provocation, small airway dysfunction was more severe in asthma patients than in subjects with asymptomatic BHR. Interestingly, a higher increase in small airway dysfunction during methacholine provocation was associated with a higher increase in Borg dyspnea scores in subjects with asymptomatic BHR, but not in asthma patients. CONCLUSION Subjects with asymptomatic BHR may experience fewer symptoms in daily life because they have less small airway dysfunction.
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Affiliation(s)
- I. M. Boudewijn
- University of Groningen; University Medical Center Groningen; Department of Pulmonary Diseases; Groningen the Netherlands
- University of Groningen; University Medical Center Groningen; Groningen Research Institute for Asthma and COPD; Groningen the Netherlands
| | - E. D. Telenga
- University of Groningen; University Medical Center Groningen; Department of Pulmonary Diseases; Groningen the Netherlands
- University of Groningen; University Medical Center Groningen; Groningen Research Institute for Asthma and COPD; Groningen the Netherlands
| | - E. van der Wiel
- University of Groningen; University Medical Center Groningen; Department of Pulmonary Diseases; Groningen the Netherlands
- University of Groningen; University Medical Center Groningen; Groningen Research Institute for Asthma and COPD; Groningen the Netherlands
| | - T. van der Molen
- University of Groningen; University Medical Center Groningen; Groningen Research Institute for Asthma and COPD; Groningen the Netherlands
- University of Groningen; University Medical Center Groningen; Department of General Practice; Groningen the Netherlands
| | - L. Schiphof
- University of Groningen; University Medical Center Groningen; Groningen Research Institute for Asthma and COPD; Groningen the Netherlands
- University of Groningen; University Medical Center Groningen; Department of General Practice; Groningen the Netherlands
| | - N. H. T. ten Hacken
- University of Groningen; University Medical Center Groningen; Department of Pulmonary Diseases; Groningen the Netherlands
- University of Groningen; University Medical Center Groningen; Groningen Research Institute for Asthma and COPD; Groningen the Netherlands
| | - D. S. Postma
- University of Groningen; University Medical Center Groningen; Department of Pulmonary Diseases; Groningen the Netherlands
- University of Groningen; University Medical Center Groningen; Groningen Research Institute for Asthma and COPD; Groningen the Netherlands
| | - M. van den Berge
- University of Groningen; University Medical Center Groningen; Department of Pulmonary Diseases; Groningen the Netherlands
- University of Groningen; University Medical Center Groningen; Groningen Research Institute for Asthma and COPD; Groningen the Netherlands
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Ramos-Ramírez P, Campos MG, Martínez-Cordero E, Bazán-Perkins B, García-Zepeda E. Antigen-induced airway hyperresponsiveness in absence of broncho-obstruction in sensitized guinea pigs. Exp Lung Res 2013; 39:136-45. [PMID: 23527782 DOI: 10.3109/01902148.2013.778921] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Airway obstruction after antigen challenge is not always observed in patients with allergic asthma, even if they develop hyperresponsiveness. A similar event is observed in our guinea pig model of allergic asthma. Our aim was to study this phenomenon. METHODS Sensitized guinea pigs were challenged with ovalbumin (OVA) 3 times every 10 days. Animals were divided into 2 groups: (1) Guinea pigs exhibiting airway obstruction after antigen challenge (R = responders), and (2) guinea pigs lacking airway obstruction response (NR = nonresponders). After the third antigen challenge, antigen-induced airway hyperresponsiveness (AI-AHR), serum OVA-specific immunoglobulins, bronchoalveolar lavage fluid (BALF) inflammatory cells, histamine, cysteinyl leukotrienes and thromboxane A2 (TxA2) BALF levels, and in vitro tracheal contraction induced by contractile mediators and OVA were evaluated. RESULTS R group consistently displayed a transient antigen-induced airway obstruction (AI-AO) as well as AI-AHR, high T×A2, histamine, OVA-IgG1, OVA-IgE and OVA-IgA levels, and intense granulocyte infiltration. NR group displayed no AI-AO and no changes in BALF measurements; nevertheless, AI-AHR and elevated OVA-IgG1 and OVA-IgA levels were observed. In all groups, histamine, TxA2 and leukotriene D4 induced a similar contraction. Tracheal OVA-induced contraction was observed only in R group. AI-AHR magnitude showed a direct association with OVA-IgG1 and OVA-IgA levels. The extent of AI-AO correlated directly with OVA-IgE and inversely with OVA-IgA levels. CONCLUSIONS Our data suggest that TxA2 and histamine participate in AI-AO likely through an IgE mechanism. AI-AHR might occur independently of AI-AO, contractile mediators release, and airway inflammatory cell infiltration, but IgA and IgG1 seem to be involved.
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Affiliation(s)
- Patricia Ramos-Ramírez
- Departamento de Hiperreactividad Bronquial, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Calzada de Tlalpan, México DF, México
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Airway function, inflammation and regulatory T cell function in subjects in asthma remission. Can Respir J 2012; 19:19-25. [PMID: 22332127 DOI: 10.1155/2012/347989] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Factors associated with asthma remission need to be determined, particularly when remission occurs in adulthood. OBJECTIVE To evaluate airway responsiveness and inflammation in adult patients in asthma remission compared with adults with mild, persistent symptomatic asthma. METHODS Adenosine monophosphate and methacholine responsiveness were evaluated in 26 patients in complete remission of asthma, 16 patients in symptomatic remission of asthma, 29 mild asthmatic patients and 15 healthy controls. Blood sampling and induced sputum were also obtained to measure inflammatory parameters. RESULTS Perception of breathlessness at 20% fall in forced expiratory volume in 1 s was similar among groups. In subjects with symptomatic remission of asthma, responsiveness to adenosine monophosphate and methacholine was intermediate between mild asthma and complete asthma remission, with the latter group similar to controls. Asthma remission was associated with a shorter duration of disease. Blood immunoglobulin E levels were significantly increased in the asthma group, and blood eosinophils were significantly elevated in the complete asthma remission, symptomatic remission and asthma groups compared with controls. The suppressive function of regulatory T cells was lower in asthma and remission groups compared with controls. CONCLUSION A continuum of asthma remission was observed, with patients in complete asthma remission presenting features similar to controls, while patients in symptomatic asthma remission appeared to be in an intermediate state between complete asthma remission and symptomatic asthma. Remission was associated with a shorter disease duration. Despite remission of asthma, a decreased suppressor function of regulatory T cells was observed, which may predispose patients to future recurrence of the disease.
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Mayer A, Pacheco K. RADS and its variants: asthma by another name. Immunol Allergy Clin North Am 2012; 33:79-93. [PMID: 23337066 DOI: 10.1016/j.iac.2012.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This article describes the different clinical variants of irritant-induced asthma, specifically focusing on high-dose irritant-induced asthma and irritant-induced work-exacerbated asthma, as well as reviews known causes, addresses the often adverse medical and socioeconomic outcomes of this complex condition, and considers issues of causation from an occupational and environmental medicine perspective.
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Affiliation(s)
- Annyce Mayer
- Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
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9
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Bougault V, Turmel J, Boulet LP. Airway hyperresponsiveness in elite swimmers: Is it a transient phenomenon? J Allergy Clin Immunol 2011; 127:892-8. [DOI: 10.1016/j.jaci.2010.11.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2010] [Revised: 10/14/2010] [Accepted: 11/04/2010] [Indexed: 11/29/2022]
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Yoshikawa T, Kanazawa H. Phenotypic differences between asymptomatic airway hyperresponsiveness and remission of asthma. Respir Med 2010; 105:24-30. [PMID: 20708396 DOI: 10.1016/j.rmed.2010.07.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 07/16/2010] [Accepted: 07/22/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND The present study aimed to illustrate differences in characteristics and perception of dyspnea between young atopic adults who have no history of asthma (never-asthmatics) with or without asymptomatic airway hyperresponsiveness (AHR) and those who had childhood asthma and consider themselves to be grown out of the disease (past-asthmatics). METHODS Blood parameters, lung function and methacholine PC(20) were measured in 88 never-asthmatics and 24 past-asthmatics. A perception score of dyspnea at 20% fall in FEV(1) (PS(20)) was obtained by interpolation of the two last points on the perception (modified Borg scale)/fall in FEV(1) curve during methacholine challenge. RESULTS Thirty-one of 88 never-asthmatics and eighteen of 24 past-asthmatics exhibited AHR (PC(20) was <8 mg/ml). Higher levels of specific IgE to house dust mite in past-asthmatics were observed than never-asthmatics with and without AHR. Mean values of FEV(1) and FEF(25-75) (%predicted) were significantly lower in past-asthmatics than never-asthmatics without AHR, and the values in never-asthmatics with AHR were intermediate between never-asthmatics without AHR and past-asthmatics. PC(20) was not significantly different between past-asthmatics and never-asthmatics with AHR. Of particular interest was that PS(20) was significantly lower in never-asthmatics with AHR compared with past-asthmatics. CONCLUSION The present findings suggest the possibilities that presence or absence of past history of outgrow of childhood asthma might be associated with airway narrowing, sensitization to house dust mite and perception of dyspnea in young asymptomatic adults with atopy and AHR.
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Affiliation(s)
- Takahiro Yoshikawa
- Department of Sports Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
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Hara J, Fujimura M, Myou S, Kita T, Abo M, Katayama N, Furusho S, Nobata K, Oribe Y, Kimura H, Sone T, Waseda Y, Ichikawa Y, Araya T, Ohkura N, Tamori S, Takato H, Tambo Y, Herai Y, Hori A, Yasui M, Kasahara K, Nakao S. Sputum eosinophilia, airway hyperresponsiveness and airway narrowing in young adults with former asthma. Allergol Int 2008; 57:211-7. [PMID: 18566550 DOI: 10.2332/allergolint.o-06-461] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2006] [Accepted: 10/15/2007] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND 30-80% of outgrown asthma subjects develop symptoms again later in life. We investigated inflammation and function of lower airway in adolescents with former asthma. METHODS 326 never-smoking young adults (mean age 24.0 years) were interviewed with special emphasis on history of asthma. Diagnosis of asthma was based on GINA guidelines. Former asthma subjects consisted of ones with a history of physician-diagnosed childhood asthma, who had been free of asthma symptoms without the use of medication for at least 10 years prior to the study. Provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 second (FEV(1))(PC(20)) and eosinophil percentage in induced sputum were measured. RESULTS 31 subjects were former asthma subjects (FBA), 11 subjects were current asthma subjects (CBA) and 284 subjects had no history of asthma (non-BA). PC(20) and FEV(1)/FVC ratio were significantly lower in the FBA group than in the non-BA group (P < 0.01). Maximal mid-expiratory flow (MMF) was significantly lower in the FBA group than in the non-BA group (P < 0.05). Sputum eosinophil percentage was significantly increased in the FBA group compared with the non-BA group (P < 0.01). PC(20) was significantly lower in the CBA group than in the FBA and non-BA groups (P < 0.01). FEV(1), FEV(1)/FVC ratio and MMF were significantly lower in the CBA group than in the FBA group (P < 0.05, P < 0.05 and P < 0.05, respectively) and the non-BA group (P < 0.01, P < 0.01 and P < 0.05, respectively). Sputum eosinophils were significantly higher in the CBA group than in the FBA and non-BA groups (P < 0.01). CONCLUSIONS This study shows that subjects with long-term outgrown asthma continue to have airway eosinophilic inflammation, airway hyperresponsiveness and airway narrowing.
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Affiliation(s)
- Johsuke Hara
- Respiratory Medicine, Cellular Transplantation Biology, Kanazawa University Graduate School of Medicine, Ishikawa, Japan.
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Sohn SW, Chang YS, Lee HS, Chung DH, Lee CT, Kim YH, Kim YK, Min KU, Kim YY, Cho SH. Atopy may be an important determinant of subepithelial fibrosis in subjects with asymptomatic airway hyperresponsiveness. J Korean Med Sci 2008; 23:390-6. [PMID: 18583872 PMCID: PMC2526529 DOI: 10.3346/jkms.2008.23.3.390] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The bronchial pathology of asymptomatic airway hyperreponsiveness (AHR) subjects is not well understood, and the role of atopy in the development of airway remodeling is unclear. The aim of this study was to evaluate whether atopy is associated with airway remodeling in asymptomatic AHR subjects. Five groups, i.e., atopic or non-atopic subjects with asymptomatic AHR, atopic or non-atopic healthy controls, and subjects with mild atopic asthma, were evaluated by bronchoscopic biopsy. By electron microscopy, mean reticular basement membrane (RBM) thicknesses were 4.3+/-1.7 microm, 3.4+/-1.8 microm, 2.5+/-1.5 microm, 2.6+/-1.1 microm, and 2.3+/-1.2 microm in the mild atopic asthma, atopic and non-atopic asymptomatic AHR, atopic and nonatopic control groups, respectively (p=0.002). RBM thicknesses were significantly higher in the mild atopic asthma group and in the atopic asymptomatic AHR group than in the other three groups (p=0.048). No significant difference in RBM thickness was observed between the atopic asymptomatic AHR group and the mild atopic asthma group (p>0.05), nor between non-atopic asymptomatic AHR group and the two control groups (p>0.05). By light microscopy, subepithelial layer thicknesses between the groups showed the same results. These findings suggest that RBM thickening occurs in subjects with atopic asymptomatic AHR, and that atopy plays an important role in airway remodeling.
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Affiliation(s)
- Seong-Wook Sohn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
- Department of Internal Medicine, Dongguk University International Hospital, Goyang, Korea
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospitial, Seongnam, Korea
| | - Hye-Seung Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Doo-Hyun Chung
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
| | - Choon-Taek Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospitial, Seongnam, Korea
| | - Young-Hwan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon-Keun Kim
- Department of Life Science, Pohang Biotechnology Center, Pohang University of Science and Technology, Pohang, Korea
| | - Kyung-Up Min
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
| | - You-Young Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
| | - Sang-Heon Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
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