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首页> 外文期刊>The European respiratory journal : >Importance of concomitant local and systemic eosinophilia in uncontrolled asthma
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Importance of concomitant local and systemic eosinophilia in uncontrolled asthma

机译：伴发的局部和全身性嗜酸粒细胞增多症在不受控制的哮喘中的重要性

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Systemic and airway eosinophilia are recognised features of asthma. There are, however, patients who exhibit discordance between local and systemic eosinophilia. In this study, we sought to determine the prevalence and characteristics of patients with concordant and discordant systemic and bronchial eosinophilia. We conducted a retrospective study on 508 asthmatics with successful sputum induction. We assessed the relationship between blood and sputum eosinophils by breaking down the population into four groups according to blood (o400 cells per mm3) and sputum (o3%) eosinophils. Then, we prospectively reassessed the link between eosinophils and asthma control (Asthma Control Questionnaire (ACQ)) and exacerbation rate in a new cohort of 250 matched asthmatics. In our retrospective cohort, asthmatics without eosinophilic inflammation were the largest group (49%). The group with isolated sputum eosinophilia (25%) was, compared with noneosinophilic asthma, associated with lower forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity ratio and higher bronchial hyperresponsiveness and exhaled nitric oxide fraction (FeNO). Asthmatics exhibiting isolated systemic eosinophilia (7%) had similar characteristics as noneosinophilic asthmatics. The group with concordant systemic and airway eosinophilia (19%) showed remarkable male predominance, and had the lowest airway calibre, asthma control and quality of life, and the highest bronchial hyperresponsiveness, FeNO and exacerbation rate. The prospective cohort confirmed the different subgroup proportions and the higher ACQ and exacerbation rates in cases of diffuse eosinophilia compared with noneosinophilic asthmatics. Concomitant systemic and bronchial eosinophilic inflammation contribute to poor asthma control.
机译：全身和气道嗜酸性粒细胞增多是哮喘的公认特征。但是，有些患者表现出局部嗜酸性粒细胞增多和全身嗜酸性粒细胞增多。在这项研究中，我们试图确定一致和不一致全身和支气管嗜酸性粒细胞增多症患者的患病率和特征。我们对成功诱导痰液的508名哮喘患者进行了回顾性研究。我们通过根据血液（每平方毫米o400个细胞）和痰（o3％）的嗜酸性粒细胞将人群分为四组来评估血液与痰嗜酸性粒细胞之间的关系。然后，我们前瞻性地重新评估了250名新的哮喘患者队列中嗜酸性粒细胞与哮喘控制（哮喘控制调查表（ACQ））和恶化率之间的联系。在我们的回顾性队列中，没有嗜酸性粒细胞炎症的哮喘患者是最大的一组（49％）。与非嗜酸性哮喘相比，孤立的痰嗜酸性粒细胞增多（25％）组与1 s的强迫呼气量（FEV1）和FEV1 /强迫肺活量比降低，支气管高反应性和呼出一氧化氮分数（FeNO）升高相关。表现出孤立的全身嗜酸性粒细胞增多（7％）的哮喘病具有与非嗜酸性哮喘病相似的特征。全身和气道嗜酸性粒细胞增多的人群（19％）表现出显着的男性优势，且气道口径，哮喘控制和生活质量最低，支气管高反应性，FeNO和恶化率最高。前瞻性队列研究证实，与非嗜酸性哮喘患者相比，弥漫性嗜酸细胞增多症患者的亚组比例不同，ACQ和急性加重率更高。伴随的全身性和支气管嗜酸性炎症导致哮喘控制不良。

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