| Risk factors associated with the presence of irreversible airflow limitation and reduced transfer coefficient in patients with asthma after 26 years of follow up. | |
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MedLine Citation:
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PMID: 12668795 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Childhood asthma is generally believed to be a disorder with a good prognosis. However, some asthmatics develop irreversible airway obstruction, probably as a result of airway remodelling. METHODS: After 21-33 years, 228 adults (aged 13-44 years at baseline) with a history of asthma were re-examined to assess risk factors for the development of irreversible airway obstruction (IAO, forced expiratory volume in 1 second (FEV(1)) <80% predicted and reversibility <9% predicted) and a reduced postbronchodilator transfer coefficient (carbon monoxide transfer factor/alveolar volume, <80% predicted), both characteristics of COPD. RESULTS: At follow up, 41% did not have airway obstruction (NAO), 43% had reversible airway obstruction (RAO), and 16% had IAO; 23% had a reduced transfer coefficient. Patients with RAO had asthma-like characteristics (wheezing, asthma attacks, bronchial hyperresponsiveness (BHR)) while patients with IAO had COPD-like symptoms (cough, phlegm, dyspnoea) at follow up. The development of IAO is determined by a lower FEV(1), less reversibility of airway obstruction and, surprisingly, less severe BHR at initial screening. Eighty percent of the patients with asthma who used anti-inflammatory medication still had airway obstruction, but IAO developed less frequently. Smoking was associated with a reduced transfer coefficient but not with the development of IAO. Female sex was associated with a reduced transfer coefficient, whereas corticosteroid use was not. CONCLUSIONS: Although IAO and a low transfer coefficient are both characteristics of COPD, they represent distinct entities in adult asthmatics in terms of symptomatology, aetiology, and probably in therapeutic approaches and disease prevention. |
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Authors:
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J M Vonk; H Jongepier; C I M Panhuysen; J P Schouten; E R Bleecker; D S Postma |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Thorax Volume: 58 ISSN: 0040-6376 ISO Abbreviation: Thorax Publication Date: 2003 Apr |
Date Detail:
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Created Date: 2003-04-01 Completed Date: 2003-05-05 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 0417353 Medline TA: Thorax Country: England |
Other Details:
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Languages: eng Pagination: 322-7 Citation Subset: IM |
Affiliation:
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Department of Epidemiology and Statistics, University of Groningen, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Airway Obstruction / etiology*, physiopathology Asthma / drug therapy, physiopathology* Bronchodilator Agents / therapeutic use Cohort Studies Female Follow-Up Studies Forced Expiratory Volume / physiology Humans Male Middle Aged Pulmonary Disease, Chronic Obstructive / etiology, physiopathology Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Bronchodilator Agents |
| Comments/Corrections | |
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