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Association between asthma control and bronchial hyperresponsiveness and airways inflammation: a cross-sectional study in daily practice.
Clin Exp Allergy 2009; 39(12):1822-9CE

Abstract

BACKGROUND

The primary end-point in the management of asthma is to obtain optimal control. The aim of this study was to assess the relationships between the markers of airway inflammation (sputum eosinophilia and exhaled nitric oxide), bronchial hyperresponsiveness (BHR) and asthma control.

METHODS

One hundred and thirty-four patients were recruited from our asthma clinic between January 2004 and September 2005 [mean age: 42 years, mean forced expiratory volume in 1 s (FEV(1)): 86% predicted]. Eighty-six of them were treated by inhaled corticosteroids, 99 were atopic and 23 were current smokers. They all underwent detailed investigations including fractional-exhaled nitric oxide (FE(NO)) measurement, sputum induction and methacholine challenge when FEV(1) was >70% predicted, and filled in a validated asthma control questionnaire (ACQ6 Juniper).

RESULTS

When dividing patients into the three groups according to their level of asthma control determined by ACQ [well-controlled asthma (ACQ score <or=0.75), borderline (0.75<ACQ score <1.5) and uncontrolled asthma (ACQ score >or=1.5)], it appeared that uncontrolled asthmatics had a greater BHR to methacholine and sputum eosinophilia than controlled asthma (P<0.05, P<0.001, respectively). By contrast, we failed to show significant differences in the FE(NO) levels between the groups. With receiver-operating characteristic curves for differentiating uncontrolled (ACQ>or=1.5) from controlled and borderline (ACQ<1.5) asthma, sputum eosinophilia and methacholine responsiveness were found to be more accurate than FE(NO) (area under the curve: 0.72, 0.72 and 0.59, respectively).

CONCLUSION

In a broad spectrum of asthmatics encountered in clinical practice, sputum eosinophilia and methacholine bronchial hyperresponsiveness, but not FE(NO), are associated with uncontrolled asthma.

Authors+Show Affiliations

Department of Respiratory Medicine, GIGA Research Center, CHU Liege, I Group, University of Liege, Liege, Belgium. vgreday@chu.ulg.ac.beNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19817755

Citation

Quaedvlieg, V, et al. "Association Between Asthma Control and Bronchial Hyperresponsiveness and Airways Inflammation: a Cross-sectional Study in Daily Practice." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 39, no. 12, 2009, pp. 1822-9.
Quaedvlieg V, Sele J, Henket M, et al. Association between asthma control and bronchial hyperresponsiveness and airways inflammation: a cross-sectional study in daily practice. Clin Exp Allergy. 2009;39(12):1822-9.
Quaedvlieg, V., Sele, J., Henket, M., & Louis, R. (2009). Association between asthma control and bronchial hyperresponsiveness and airways inflammation: a cross-sectional study in daily practice. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 39(12), pp. 1822-9. doi:10.1111/j.1365-2222.2009.03332.x.
Quaedvlieg V, et al. Association Between Asthma Control and Bronchial Hyperresponsiveness and Airways Inflammation: a Cross-sectional Study in Daily Practice. Clin Exp Allergy. 2009;39(12):1822-9. PubMed PMID: 19817755.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between asthma control and bronchial hyperresponsiveness and airways inflammation: a cross-sectional study in daily practice. AU - Quaedvlieg,V, AU - Sele,J, AU - Henket,M, AU - Louis,R, Y1 - 2009/10/08/ PY - 2009/10/13/entrez PY - 2009/10/13/pubmed PY - 2010/4/17/medline SP - 1822 EP - 9 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin. Exp. Allergy VL - 39 IS - 12 N2 - BACKGROUND: The primary end-point in the management of asthma is to obtain optimal control. The aim of this study was to assess the relationships between the markers of airway inflammation (sputum eosinophilia and exhaled nitric oxide), bronchial hyperresponsiveness (BHR) and asthma control. METHODS: One hundred and thirty-four patients were recruited from our asthma clinic between January 2004 and September 2005 [mean age: 42 years, mean forced expiratory volume in 1 s (FEV(1)): 86% predicted]. Eighty-six of them were treated by inhaled corticosteroids, 99 were atopic and 23 were current smokers. They all underwent detailed investigations including fractional-exhaled nitric oxide (FE(NO)) measurement, sputum induction and methacholine challenge when FEV(1) was >70% predicted, and filled in a validated asthma control questionnaire (ACQ6 Juniper). RESULTS: When dividing patients into the three groups according to their level of asthma control determined by ACQ [well-controlled asthma (ACQ score <or=0.75), borderline (0.75<ACQ score <1.5) and uncontrolled asthma (ACQ score >or=1.5)], it appeared that uncontrolled asthmatics had a greater BHR to methacholine and sputum eosinophilia than controlled asthma (P<0.05, P<0.001, respectively). By contrast, we failed to show significant differences in the FE(NO) levels between the groups. With receiver-operating characteristic curves for differentiating uncontrolled (ACQ>or=1.5) from controlled and borderline (ACQ<1.5) asthma, sputum eosinophilia and methacholine responsiveness were found to be more accurate than FE(NO) (area under the curve: 0.72, 0.72 and 0.59, respectively). CONCLUSION: In a broad spectrum of asthmatics encountered in clinical practice, sputum eosinophilia and methacholine bronchial hyperresponsiveness, but not FE(NO), are associated with uncontrolled asthma. SN - 1365-2222 UR - https://www.unboundmedicine.com/medline/citation/19817755/Association_between_asthma_control_and_bronchial_hyperresponsiveness_and_airways_inflammation:_a_cross_sectional_study_in_daily_practice_ L2 - https://doi.org/10.1111/j.1365-2222.2009.03332.x DB - PRIME DP - Unbound Medicine ER -