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Small Airway Dysfunction in Asthma Is Associated with Perceived Respiratory Symptoms, Non-Type 2 Airway Inflammation, and Poor Responses to Therapy.
- Source :
-
Respiration . Aug2021, Vol. 100 Issue 8, p767-779. 13p. - Publication Year :
- 2021
-
Abstract
- Background: Emerging evidence has indicated that small airway dysfunction (SAD) contributes to the clinical expression of asthma. Objectives: The aim of the study was to explore the relationships of SAD assessed by forced expiratory flow between 25 and 75% (FEF25–75%), with clinical and inflammatory profile and treatment responsiveness in asthma. Method: In study I, dyspnea intensity (Borg scale), chest tightness, wheezing and cough (visual analog scales, VASs), and pre- and post-methacholine challenge testing (MCT) were analyzed in asthma patients with SAD and non-SAD. In study II, asthma subjects with SAD and non-SAD underwent sputum induction, and inflammatory mediators in sputum were detected. Asthma patients with SAD and non-SAD receiving fixed treatments were prospectively followed up for 4 weeks in study III. Spirometry, Asthma Control Questionnaire (ACQ), and Asthma Control Test (ACT) were carried out to define treatment responsiveness. Results: SAD subjects had more elevated ΔVAS for dyspnea (p = 0.027) and chest tightness (p = 0.032) after MCT. Asthma patients with SAD had significantly elevated interferon (IFN)-γ in sputum (p < 0.05), and Spearman partial correlation found FEF25–75% significantly related to IFN-γ and interleukin-8 (both having p < 0.05). Furthermore, multivariable regression analysis indicated SAD was significantly associated with worse treatment responses (decrease in ACQ ≥0.5 and increase in ACT ≥3) (p = 0.022 and p = 0.032). Conclusions: This study indicates that SAD in asthma predisposes patients to greater dyspnea intensity and chest tightness during bronchoconstriction. SAD patients with asthma are characterized by non-type 2 inflammation that may account for poor responsiveness to therapy. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ASTHMA treatment
*INTERLEUKINS
*STATISTICS
*INFLAMMATION
*SPUTUM
*BRONCHOCONSTRICTION
*AIRWAY (Anatomy)
*VISUAL analog scale
*RESPIRATORY measurements
*REGRESSION analysis
*RESPIRATORY obstructions
*TREATMENT effectiveness
*RISK assessment
*DYSPNEA
*SEVERITY of illness index
*RESPIRATORY organ sounds
*INTERFERONS
*FORCED expiratory volume
*CHEST pain
*COUGH
*QUESTIONNAIRES
*SPIROMETRY
*DATA analysis
*DISEASE complications
*EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 00257931
- Volume :
- 100
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- Respiration
- Publication Type :
- Academic Journal
- Accession number :
- 151756374
- Full Text :
- https://doi.org/10.1159/000515328