Yıldız Tekin, Dülger Seyhan
Department of Pulmonary Diseases, Bursa Yüksek İhtisas Training and Research Hospital, Health Sciences University, Bursa, Turkey.
Turk Thorac J. 2018 Jan;19(1):41-45. doi: 10.5152/TurkThoracJ.2017.17017. Epub 2017 Sep 27.
Non-asthmatic eosinophilic bronchitis (NAEB) is eosinophilic inflammation of the respiratory tract, without any bronchospasm. In this article, we want to draw attention to the NAEB. It should also be considered in differential diagnosis of chronic cough. Eosinophilia is present in all induced or spontaneous sputum samples of NAEB patients. NAEB patients and asthmatic patients have similar airway inflammation. Remarkably, NAEB mainly occurs in the lower airways. Unlike asthma, mast cells in NAEB are active in the bronchial epithelium. Diagnosis is based on the clinical, radiological, and spirometric measurements of other causes of chronic cough (Post-nasal discharge syndrome, asthma, gastroesophageal reflux etc.) and the assessment of inflammation in the lower respiratory tract. Airway inflammation can be assessed by sputum induction. The main treatment is anti-inflammatory therapy with inhaled corticosteroids and taking protective measures if inflammation is due to occupational exposure or allergen inhalation. If NAEB is untreated, it may be transient, episodic, or persistent; rarely, long-term oral steroid treatment may be required in patients. There is a requirement for studies that investigate the role of non-invasive markers of chronic inflammation associated with NAEB and the effectiveness of other treatments.
非哮喘性嗜酸性粒细胞性支气管炎(NAEB)是一种呼吸道嗜酸性粒细胞炎症,不存在任何支气管痉挛。在本文中,我们希望引起对NAEB的关注。在慢性咳嗽的鉴别诊断中也应考虑到它。NAEB患者所有诱导痰或自发痰样本中均存在嗜酸性粒细胞增多。NAEB患者和哮喘患者具有相似的气道炎症。值得注意的是,NAEB主要发生在下呼吸道。与哮喘不同,NAEB中的肥大细胞在支气管上皮中活跃。诊断基于对慢性咳嗽其他病因(鼻后滴漏综合征、哮喘、胃食管反流等)的临床、放射学和肺功能测量,以及对下呼吸道炎症的评估。气道炎症可通过诱导痰进行评估。主要治疗方法是吸入糖皮质激素进行抗炎治疗,如果炎症是由于职业暴露或吸入过敏原引起的,则采取保护措施。如果NAEB未经治疗,它可能是短暂性、发作性或持续性的;很少情况下,患者可能需要长期口服类固醇治疗。需要开展研究来调查与NAEB相关的慢性炎症非侵入性标志物的作用以及其他治疗方法的有效性。