Document Detail


Clinical control of asthma associates with measures of airway inflammation.
MedLine Citation:
PMID:  23042704     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Control of asthma is the goal of asthma management worldwide. The Global Initiative for Asthma defined control by a composite measure of clinical findings and future risk but without using markers of airway inflammation, the hallmark of asthma. We investigated whether clinical asthma control reflects eosinophilic inflammation in a broad population.
METHODS: Control of asthma was assessed over a period of 4 weeks in 111 patients with asthma: 22 totally controlled, 47 well controlled and 42 uncontrolled. Lung function, quality of life, airway hyperresponsiveness to AMP, sputum and blood eosinophils, exhaled nitric oxide (NO) and bronchial biopsies were obtained.
RESULTS: The 69 subjects with controlled asthma (totally and well controlled combined) had lower median blood eosinophil numbers, slope of AMP hyperresponsiveness, and alveolar NO levels than the 42 subjects with uncontrolled asthma: 0.18 (range 0.01-0.54) versus 0.22 (0.06-1.16) × 10(9)/litre (p<0.05), 3.8 (-0.4-17 750) versus 39.7 (0.4-28 000) mg/ml (p<0.05) and 5.3 (1.5-14.9) versus 6.7 (2.6-51.7) ppb (p<0.05) respectively. Biopsies from subjects with controlled asthma contained fewer eosinophilic granules and more intact epithelium than uncontrolled subjects: 113 (6-1787) versus 219 (19-5313) (p<0.05) and 11.8% (0-65.3) versus 5.6% (0-47.6) (p<0.05) respectively. Controlled asthmatics had better Asthma Quality of Life Questionnaire scores than uncontrolled patients: 6.7 (5.0-7.0) versus 5.9 (3.7-7.0) (p<0.001).
CONCLUSIONS: The level of asthma control, based on a composite measure of clinical findings, is associated with inflammatory markers, particularly eosinophilic inflammation, with little difference between totally controlled and well controlled asthma.
Authors:
Franke Volbeda; Martine Broekema; Monique E Lodewijk; Machteld N Hylkema; Helen K Reddel; Wim Timens; Dirkje S Postma; Nick H T ten Hacken
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-10-06
Journal Detail:
Title:  Thorax     Volume:  68     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-11     Completed Date:  2013-02-08     Revised Date:  2013-03-22    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  19-24     Citation Subset:  IM    
Affiliation:
Department of Pulmonology, University Medical Centre Groningen, Groningen and University of Groningen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Asthmatic Agents / administration & dosage*
Asthma / drug therapy*,  immunology,  pathology*
Biopsy, Needle
Breath Tests / methods
Bronchial Hyperreactivity / physiopathology
Bronchoalveolar Lavage / methods
Cross-Sectional Studies
Eosinophilia / physiopathology*
Female
Forced Expiratory Volume
Humans
Immunohistochemistry
Inflammation / physiopathology*
Inflammation Mediators / analysis
Logistic Models
Male
Middle Aged
Multivariate Analysis
Nitric Oxide / analysis*
Prognosis
Prospective Studies
Quality of Life
Respiratory Function Tests
Risk Assessment
Severity of Illness Index
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Asthmatic Agents; 0/Inflammation Mediators; 10102-43-9/Nitric Oxide
Comments/Corrections
Comment In:
Thorax. 2013 Mar;68(3):295   [PMID:  23242948 ]
Thorax. 2013 Mar;68(3):295-6

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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