Article (Scientific journals)
Importance of concomitant local and systemic eosinophilia in uncontrolled asthma.
SCHLEICH, FLorence; Chevremont, Anne; PAULUS, Virginie et al.
2014In European Respiratory Journal, 44, p. 97-108
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Abstract :
[en] 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 (>/=400 cells per mm3) and sputum (>/=3%) 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, ACQ score 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.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
SCHLEICH, FLorence ;  Centre Hospitalier Universitaire de Liège - CHU > Pneumologie-Allergologie
Chevremont, Anne 
PAULUS, Virginie ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Clinique de l'asthme
HENKET, Monique ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Clinique de l'asthme
Manise, Maïté ;  Université de Liège - ULiège > Département des sciences cliniques > Pneumologie - Allergologie
Seidel, Laurence  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Informatique médicale et biostatistique
Louis, Renaud ;  Université de Liège - ULiège > Département des sciences cliniques > Pneumologie - Allergologie
Language :
English
Title :
Importance of concomitant local and systemic eosinophilia in uncontrolled asthma.
Publication date :
2014
Journal title :
European Respiratory Journal
ISSN :
0903-1936
eISSN :
1399-3003
Publisher :
European Respiratory Society, United Kingdom
Volume :
44
Pages :
97-108
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 15 May 2014

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