Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Université de Montréal, Montréal, Quebec, Canada.
CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Barcelona, Spain.
PLoS One. 2018 Mar 2;13(3):e0193144. doi: 10.1371/journal.pone.0193144. eCollection 2018.
Although Asthma-COPD Overlap (ACO) has been described among populations of subjects with COPD or asthma, ACO has never been described among a population of subjects with occupational asthma (OA).
The aims of this study were to: 1. identify ACO in a population of subjects with OA; and 2. compare the clinical characteristics between ACO and OA.
This retrospective study included all subjects diagnosed with OA between 2000 and 2017 in an OA referral center. Occupational Asthma-COPD Overlap (OACO) was defined as post-bronchodilator FEV1/FVC < 70% and smoking history ≥ 10 pack-years, along with a diagnosis of OA.
Three hundred and four subjects were included, 262 (86.2%) were classified as OA and 42 (13.8%) as OACO. OA subjects presented higher sputum eosinophil counts after a specific-inhalation challenge than subjects with OACO (median [IQR]: 6.5 [17.0] vs 2.3 [3.5]). After adjusting for confounding factors, subjects with OACO were older (OR: 1.10 [1.05; 1.14]) and were taking higher doses of inhaled corticosteroids than OA subjects (OR, 5.20 [1.77; 16.48]). Subjects with OACO were less often atopic than OA subjects (OR, 0.19 [0.07; 0.62]).
Subjects with OACO constitute a distinct clinical and inflammatory phenotype from subjects with OA.
虽然哮喘-慢性阻塞性肺疾病重叠（ACO）在 COPD 或哮喘患者人群中已有描述，但在职业性哮喘（OA）患者人群中从未描述过 ACO。
本研究的目的是：1. 在 OA 患者人群中确定 ACO；2. 比较 ACO 和 OA 的临床特征。
本回顾性研究纳入了 2000 年至 2017 年间在 OA 转诊中心诊断为 OA 的所有患者。职业性哮喘-慢性阻塞性肺疾病重叠（OACO）定义为支气管扩张剂后 FEV1/FVC<70%且吸烟史≥10 包年，同时诊断为 OA。
共纳入 304 例患者，262 例（86.2%）归类为 OA，42 例（13.8%）归类为 OACO。与 OACO 患者相比，OA 患者在特定吸入性挑战后痰液嗜酸性粒细胞计数更高（中位数[IQR]：6.5[17.0]比 2.3[3.5]）。在校正混杂因素后，OACO 患者年龄更大（OR：1.10[1.05; 1.14]），吸入性皮质激素剂量高于 OA 患者（OR，5.20[1.77; 16.48]）。与 OA 患者相比，OACO 患者的变应性较低（OR，0.19[0.07; 0.62]）。
与 OA 患者相比，OACO 患者构成了一种独特的临床和炎症表型。
