Asthma and risk of bronchiectasis exacerbation: we still need more evidence. Issue 4 (October 2016)

• Record Type: Journal Article
• Authors: Mao, Bei; Yang, Jia-Wei; Lu, Hai-Wen; Xu, Jin-Fu
• Is Part Of: European respiratory journal. Volume 48:Issue 4(2016)
• Page Start: 1247
• Page End: 1248
• Publication Date: 2016-10
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.00979-2016
• Languages: English
• ISSNs: 0903-1936

Abstract

According to our study, although more evidence is needed, the existence of asthma is associated with an independent increase in risk of bronchiectasis exacerbation [1]. Bronchiectasis and asthma share some similarities in clinical characteristics and bronchial hyperresponsiveness, which would bring some diagnostic challenges of asthma in bronchiectasis patients. As shown by Guan et al. [2], reversible airway obstruction or hyperresponsiveness can occur in patients with bronchiectasis. If the extent of reversibility in those patients meets the diagnostic criteria of asthma, they should also be diagnosed with asthma. In our study, the diagnosis and recruitment of subjects was in strict accordance with the relevant guidelines [1, 3–6]. Diagnosis of bronchiectasis was performed using chest high-resolution computed tomography scans in suspected patients with coughing and expectoration, or long durations of haemoptysis. An exacerbation is defined as the patient reporting four or more of the following symptoms: change in sputum production, increased dyspnoea, increased cough, fever >38°C, increased wheezing, decreased exercise tolerance, fatigue, malaise, lethargy, reduced pulmonary function, changes in chest sounds, or radiographic changes consistent with a new infectious process [1, 3, 4]. Asthma was diagnosed for patients with symptoms such as episodic breathlessness, wheezing, cough and chest tightness, and whose spirometry showed bronchial reversibility of 12% and 200 mL from the pre-bronchodilator value or airway hyperresponsiveness as a 20% decrease in forced expiratory volume in 1 s (FEV1 ) caused by a provocative histamine with a cumulative dose <2.4 mg [5, 6]. Asthma increases the risk of bronchiectasis exacerbation; however, more evidence is needed http://ow.ly/dWm0300OcFj