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Background: Asthma often coexists with chronic rhinosinusitis (CRS). Recent studies revealed that sinus inflammation in asthmatic patients was related to eosinophilic inflammation. However, the relationship between the severity of CRS and four different sputum inflammatory phenotypes as defined by the proportion of eosinophils and neutrophils is unknown. The aim of this study was to examine the impact of the severity of CRS on lower airway and systemic inflammation in asthmatic patients. Methods: We enrolled 57 adult asthmatic patients who underwent sinus computed tomography (CT). The severity of CRS was evaluated by the Lund-Mackay score (LMS). The induced sputum inflammatory phenotype was defined by eosinophils (≥/

Invasive tracheobronchial aspergillosis (ITBA), a rare form of invasive pulmonary Aspergillus infection (IPA), is predominantly confined to the tracheobronchial tree. We herein report a case of ITBA with severe necrotic pseudomembrane in a 57-year-old woman with fulminant hepatitis and hemophagocytic syndrome. Bronchoscopic findings revealed a widespread pseudomembranous formation of the trachea and bronchi. Aspergillus fumigatus was cultured from bronchial lavage fluid, and the histological findings of an endobronchial biopsy revealed necrosis and invasive hyphae. Although she responded to antifungal treatment, she ultimately died of a septic shock with Burkholderia cepacia 57 days after admission.

Background: We previously reported the numbers of sputum basophils are positively correlated with the numbers of sputum eosinophils in asthmatic patients. However, it remains unknown whether increasing airway basophils indicate a specific inflammatory phenotype or not. Objectives: The aim of this study is to clarify the specific phenotype increasing sputum basophils. Methods: We analyzed induced sputum samples from adult asthmatic patients who were treated with ICS more than 2 months. Sputum basophils were examined by flow cytometry and sputum eosinophils and neutrophils were examined under microscopy. The airway inflammation was divided into 4 subtypes, which are paucicellular type (neutrophils 60%, eosinophils 2%) and mixed cellular type (neutrophils >60%, eosinophils>2%). Chronic sinusitis was evaluated by CT scan and scored by the Lund-Mackay system. Results: Sixty-eight samples were examined. Sputum basophils were increased in eosinophilic type. On the other hand, the numbers of sputum basophils were not increased in mixed cellular type as well as paucicellular type and neutrophilic type. CT scan to evaluate chronic sinusitis revealed a positive correlation between the numbers of sputum basophils and ethmoid scores. Conclusion: Increasing sputum basophils were observed in eosinophil-dominant inflammtion but not in mixed cellular inflammation. Airway basophils may be a useful biomarker to select appropriate therapies in biologics era.

Background: Periostin is an extracellular matrix protein that reflects airway epithelial injury. In asthma, periostin is considered to be useful as a biomarker of type 2 inflammation. In addition, it has been reported that periostin associates with respiratory diseases such as idiopathic pulmonary fibrosis. However, it is unknown that the relationship between periostin and other biomarkers in chronic obstructive pulmonary disease (COPD). Objective: We investigated the relationship between serum periostin levels and other biomarkers including serum markers and pulmonary function. Methods: Ninety-three COPD patients were enrolled, and we reviewed associations among serum periostin, other serum biomarkers and clinical features. Results: Fractional exhaled nitric oxide (FeNO), IgE, and age showed correlations with serum periostin levels respectively, whereas blood eosinophils and stages of COPD showed no correlations. Conclusion: Periostin may be a useful biomarker of type 2 inflammation in COPD.