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Inflammatory subtypes in cough-variant asthma: association with maintenance doses of inhaled corticosteroids
- Source :
- Chest. 138(6)
- Publication Year :
- 2010
-
Abstract
- Sputum cell-subtype profiles in cough-variant asthma (CVA) are unknown.Ninety-eight inhaled corticosteroid (ICS)-naive CVA patients were classified according to sputum eosinophil (eos)/neutrophil (neu) counts, as reported in subjects with asthma, as eosinophilic (E) (eos ≥ 1.0%, neu61%; n = 28), neutrophilic (N) (eos1.0%, neu ≥ 61%; n = 31), mixed granulocytic (M) (eos ≥ 1.0%, neu ≥ 61%; n = 12), and paucigranulocytic (P) (eos1.0%, neu61%; n = 27) subtypes. Patient characteristics; sputum levels of eosinophil cationic protein (ECP), IL-8, and neutrophil elastase (NE); and daily ICS doses required to maintain control during follow-up (6, 12, 18, and 24 months) were compared, retrospectively.Subtype N patients, predominantly women, were marginally older than the other subtypes, but FEV(1), airway responsiveness, and total and specific IgE results did not differ. ECP levels were higher in M and E than in N and P subtypes, being similar between M and E or N and P subtypes. Levels of IL-8 and NE were higher in M than in other subtypes, being similar among the latter. ICS doses were initially similar in all subtypes (800 μg equivalent of beclomethasone) but were higher in M than in N and P subtypes throughout follow-up, with E being intermediate between M and N or P subtypes. ICS doses decreased (halved or quartered) in E, N, and P patients followed for 24 months (P.0001 for all) but remained unchanged in M subjects. IL-8 and NE levels correlated positively with ECP levels.In addition to eosinophils, neutrophils, which are possibly activated in the presence of eosinophils, may participate in the pathophysiology of CVA.
- Subjects :
- Adult
Male
Analysis of Variance
Dose-Response Relationship, Drug
Neutrophils
Sputum
Pneumonia
Middle Aged
Severity of Illness Index
Asthma
Bronchial Provocation Tests
Drug Administration Schedule
Statistics, Nonparametric
Cohort Studies
Eosinophils
Leukocyte Count
Treatment Outcome
Cough
Adrenal Cortex Hormones
Administration, Inhalation
Humans
Female
Follow-Up Studies
Subjects
Details
- ISSN :
- 19313543
- Volume :
- 138
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Chest
- Accession number :
- edsair.pmid..........b157e7b811f3e0249cd34a6f3da60c72