Servei de Pneumologia, Hospital Universitari Vall d́Hebron, Departament de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.
Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.
Arch Bronconeumol. 2023 Nov;59(11):736-742. doi: 10.1016/j.arbres.2023.07.026. Epub 2023 Aug 5.
The risk factors for having frequent exacerbations are not well documented in cohort studies of patients with asthma on existing therapy. The objective of the present study was to compare the clinical and inflammatory characteristics of patients with exacerbation-prone asthma (EPA) with a history of two or more exacerbations in the previous year with those who had presented just one or no exacerbation.
An ambispective observational study was conducted in a tertiary hospital. Patients diagnosed with moderate or severe asthma and ongoing therapy, whose inflammatory profile was determined by means of allergy and atopy status, blood eosinophilia and induced sputum were included. Patients were classified according to the number of asthma exacerbations in EPA (≥2 exacerbations in the previous year) vs. non-exacerbators (≤1 exacerbation in the previous year). Clinical, lung function and inflammatory characteristics of the two groups were compared.
Three hundred ten patients were visited in the Asthma Unit in 2018 and the combination of atopy and allergy status, blood eosinophilia and induced sputum was obtained in 96 (31%) patients. Of this latter group, 46 patients (47%) presented EPA compared to 50 (53%) non-exacerbators. Airway and blood eosinophilic inflammation did not differ between EPA and non-exacerbators in patients with asthma and ongoing therapy, and it was not a risk factor for EPA in our cohort.
Airway or blood type 2 inflammation status is not a valid tool for recognizing EPA or predicting asthma exacerbations in asthma patients following controller therapy.
在接受现有治疗的哮喘患者的队列研究中，频繁加重的风险因素尚未得到很好的记录。本研究的目的是比较具有频发哮喘（EPA）病史（过去一年有两次或两次以上加重）和仅有一次或无加重史的患者的临床和炎症特征。
在一家三级医院进行了一项前瞻性观察研究。纳入了诊断为中重度哮喘且正在接受治疗、通过过敏和特应性状态、血嗜酸性粒细胞和诱导痰确定炎症特征的患者。根据 EPA 中哮喘加重的次数（过去一年中≥2 次加重）和非加重者（过去一年中≤1 次加重）对患者进行分类。比较两组患者的临床、肺功能和炎症特征。
2018 年在哮喘科共对 310 例患者进行了访视，在获得过敏和特应性状态、血嗜酸性粒细胞和诱导痰的 96 例（31%）患者中。在这一组中，46 例（47%）患者为 EPA，而非 EPA 患者为 50 例（53%）。在接受控制治疗的哮喘患者中，EPA 和非 EPA 患者的气道和血液嗜酸性粒细胞炎症无差异，并且在我们的队列中，它不是 EPA 的危险因素。
在接受控制治疗的哮喘患者中，气道或血液 2 型炎症状态不是识别 EPA 或预测哮喘加重的有效工具。
