Airway Inflammation and Cellular Stress in Noneosinophilic Atopic Asthma

Tsoumakidou, Maria; Papadopouli, Evangelia; Tzanakis, Νikolaos; Siafakas, Nikolaos M.

doi:10.1378/chest.129.5.1194

Cited by 16 publications

(12 citation statements)

References 41 publications

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“…Asthma without rhinitis appears to be characterized by fewer eosinophils. Other investigators have described sub-groups of asthmatics with low levels of eosinophils in induced sputum[16, 17], they appear less likely to respond to inhaled corticosteroid therapy[18, 19]. Inferring from these previous studies, asthmatics without rhinitis may be less likely to respond to inhaled corticosteroid therapy, though this would require further investigation.…”

Section: Discussionmentioning

confidence: 94%

Lower Airway Disease in Asthmatics with and without Rhinitis

Dixon

Raymond

Suratt

et al. 2008

Lung

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Study Objectives-The purpose of this study was to determine if asthma with and without rhinitis represent distinct forms of disease.Design-A prospective cross-sectional study.Participants-Healthy controls, participants with asthma without rhinitis, and participants with both asthma and rhinitis Interventions-We compared lung function and airway inflammation between the three groups of participants. Conclusions-Asthmatics without rhinitis tend to have lower lung function and less eosinophilic inflammation in the lung. This study suggests that asthmatics without rhinitis represent a distinct phenotype of asthma in which low lung function is dissociated from eosinophilic cellular inflammation. Results-We

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Section: Discussionmentioning

confidence: 94%

Lower Airway Disease in Asthmatics with and without Rhinitis

Dixon

Raymond

Suratt

et al. 2008

Lung

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“…The use of induced sputum as well as lavage and fiberoptic bronchoscopy has revealed that some patients with asthma have a sputum neutrophilia in the absence of eosinophils (Wenzel et al 1999;Tsoumakidou et al 2006). Other studies have noted neutrophilic inflammation in some patients with severe asthma and during virusinduced exacerbations (Wark et al 2002).…”

Section: Noneosinophilic Asthmamentioning

confidence: 99%

Pathogenesis of Asthma

Holgate¹

2008

Clin Experimental Allergy

678

486

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While asthma is considered an inflammatory disorder of the conducting airways, it is becoming increasingly apparent that the disease is heterogeneous with respect to immunopathology, clinical phenotypes, response to therapies, and natural history. Once considered purely an allergic disorder dominated by Th2-type lymphocytes, IgE, mast cells, eosinophils, macrophages, and cytokines, the disease also involves local epithelial, mesenchymal, vascular and neurologic events that are involved in directing the Th2 phenotype to the lung and through aberrant injury-repair mechanisms to remodeling of the airway wall. Structural cells provide the necessary "soil" upon which the "seeds" of the inflammatory response are able to take root and maintain a chronic phenotype and upon which are superimposed acute and subacute episodes usually driven by environmental factors such as exposure to allergens, microorganisms, pollutants or caused by inadequate antiinflammatory treatment. Greater consideration of additional immunologic and inflammatory pathways are revealing new ways of intervening in the prevention and treatment of the disease. Thus increased focus on environmental factors beyond allergic exposure (such as virus infection, air pollution, and diet) are identifying targets in structural as well as immune and inflammatory cells at which to direct new interventions.

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“…This fact may be expected, considering that ECP release from eosinophils depends on their activation status: few eosinophils, when highly activated by specific and/or increased degranulating agents, may release large amounts of ECP, whereas large numbers of eosinophils may be associated with low levels of ECP if not activated. As a matter of fact, it has been reported that patients with noneosinophilic airway disease, such as COPD or non-eosinophilic severe asthma, may have high sputum ECP levels; on the other hand, classic eosinophilic asthma may be associated with normal sputum ECP levels [9,13]. All these observations suggest that not only the number of eosinophils (as demonstrated by some interventional studies) [26] but also their activation degree (ECP levels) should be considered in the evaluation of asthma severity or activity.…”

Section: Discussionmentioning

confidence: 99%