Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
Expert Rev Respir Med. 2021 Mar;15(3):419-424. doi: 10.1080/17476348.2021.1840983. Epub 2020 Nov 3.
Several severe asthma comorbidities have been identified: an emerging one is bronchiectasis. We evaluated the frequency of bronchiectasis on severe asthma in a real-life setting, through the 'Severe Asthma Network Italy' (SANI) registry.
SANI registry encompasses demographic, clinical, functional and inflammatory data of Italian severe asthmatics. Data obtained by the enrolled patients were analyzed, focusing the attention on those patients with concomitant clinically relevant bronchiectasis.
About 15.5% patients have bronchiectasis. Bronchiectasis diagnosis was associated with a higher prevalence of chronic rhinosinusitis with nasal polyps (54.6% vs. 38%, p = 0.001) and higher serum IgE levels (673.4 vs. 412.1 kUI/L, p = 0.013). Patients with bronchiectasis had worse asthma control (ACT: 16.7 vs 18.2, p = 0.013), worse quality of life (AQLQ: 4.08 vs. 4.60, p = 0.02) and lower lung function (FEV% predicted 67.3 vs. 75.0, p = 0.002). A higher rate of severe asthma exacerbations in the previous 12 months (85.2% vs. 61.5%, p < 0.001) was found in patients with bronchiectasis.
severe asthma associated with bronchiectasis represents a particularly severe asthma variant, possibly driven by an eosinophilic endotype. We, therefore, suggest that bronchiectasis should necessarily be assessed in severe asthmatic patients.
已经确定了几种严重哮喘合并症：一种新兴的合并症是支气管扩张症。我们通过“意大利严重哮喘网络”（SANI）登记处，在真实环境中评估严重哮喘患者中支气管扩张症的频率。
SANI 登记处包含意大利严重哮喘患者的人口统计学、临床、功能和炎症数据。分析了登记患者的数据，重点关注伴有临床相关支气管扩张症的患者。
约 15.5%的患者患有支气管扩张症。支气管扩张症的诊断与慢性鼻-鼻窦炎伴鼻息肉（54.6% vs. 38%，p = 0.001）和更高的血清 IgE 水平（673.4 vs. 412.1 kUI/L，p = 0.013）的患病率更高相关。患有支气管扩张症的患者哮喘控制更差（ACT：16.7 vs 18.2，p = 0.013）、生活质量更差（AQLQ：4.08 vs. 4.60，p = 0.02）和肺功能更差（FEV%预测值 67.3 vs. 75.0，p = 0.002）。支气管扩张症患者在过去 12 个月内有更高比例的严重哮喘加重（85.2% vs. 61.5%，p < 0.001）。
伴有支气管扩张症的严重哮喘代表一种特别严重的哮喘变异体，可能由嗜酸性粒细胞表型驱动。因此，我们建议在严重哮喘患者中必须评估支气管扩张症。
