Factors associated with bronchiectasis in patients with uncontrolled asthma; the NOPES score: a study in 398 patients

Padilla-Galo, Alicia; Olveira, Casilda; Rota-Garcia, Luis Fernandez de; Marco-Galve, I.; Plata, Antonio; Álvarez, Antonio; Rivas-Ruiz, Francisco; Carmona-Olveira, A.; Cebrian-Gallardo, Jose Joaquin; Martínez-García, Miguel Ángel

doi:10.1186/s12931-018-0746-7

Cited by 70 publications

(69 citation statements)

References 57 publications

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“…The prevalence of asthma was 19.10% in the patients with bronchiectasis in our study. A. Padilla-Galo et al reported a high prevalence of bronchiectasis in patients with uncontrolled asthma [26]. We need to focus on the high prevalence of asthma or asthma characteristics in patients with bronchiectasis.…”

Section: Discussionmentioning

confidence: 99%

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Role of noninvasive methods for assessing stable non-cystic fibrosis bronchiectasis

Chen¹,

Lin²,

Ye³

et al. 2020

Preprint

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Background: Bronchiectasis is characterized by the abnormal dilation of lung airways. Only some patients with bronchiectasis may clinically benefit from the treatment recommended in the guidelines of the European Respiratory Society. The value of noninvasive methods for assessing the clinical phenotypes of stable-state non-cystic ﬁbrosis (non-CF) bronchiectasis for treatable characteristics has not been adequately studied.Methods: Eighty-nine patients with stable non-CF bronchiectasis were retrospectively enrolled. Patient characteristics, fractional exhaled nitric oxide (FeNO) values, and the results of blood tests for inflammatory markers, pulmonary function test, high-resolution computed tomography (HRCT), and bronchial hyper-responsiveness test or bronchodilator reversibility test were obtained. These data were used to assess the factors associated with the clinical phenotype of bronchiectasis.Results: The majority of the patients were female (60.67%) and have an average age of 59.08±15.09 years old. The predicted percentages of forced expiratory volume in 1 s (FEV1) and the ratio of FEV1 and forced vital capacity were 56.17%±23.16% and 65.58%±15.26%, respectively. Eighteen (20.22%) of the patients with bronchiectasis had emphysema. The presence of emphysema in bronchiectasis was associated with a high airflow obstruction level. Seventeen (10.10%) of the patients with bronchiectasis had asthma. FeNO was signiﬁcantly higher in the group of patients with bronchiectasis and asthma than in the other two groups (p < 0.01). The erythrocyte sedimentation rate (ESR) of the bronchiectasis alone group was higher than those of the other two groups. Signiﬁcant negative correlations were found between ERS and FeNO levels (p = 0.02, r = −0.338), between HRCT score and FeNO levels (p = 0.04, r = −0.229), and between FEV1 (% predicted) and HRCT scores (p = 0.0007, r = −0.3629). A signiﬁcant positive correlation was found between ERS and HRCT scores (p = 0.0001, r = 6326).Conclusion: A remarkable proportion of patients with bronchiectasis have emphysema or asthma. Biomarkers, such as FeNO, and conventional lung function tests should be routinely used for phenotyping bronchiectasis for potential targeted therapy. ESR can be used as a biomarker to reflect the level of systemic inﬂammation and the severity of bronchiectasis. These approaches will provide a better understanding of patients with bronchiectasis and their clinical phenotypes and lead to a more individualized and effective therapy.

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Section: Discussionmentioning

confidence: 99%

“…Some patients with bronchiectasis may have eosinophilia, elevated IgE, and at least partially reversible airway obstruction or hyper-responsiveness, which suggest an asthmatic component [26].…”

Section: Discussionmentioning

confidence: 99%

Role of noninvasive methods for assessing stable non-cystic fibrosis bronchiectasis

Chen¹,

Lin²,

Ye³

et al. 2020

Preprint

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“…Exhaled nitric oxide (FeNO), an important diagnostic parameter for the evaluation of the upper airways' inflammation, is used in the clinical practice for evaluating the asthmatic disease [62]. It is recently also been considered for the evaluation of the inflammatory status in patients with bronchiectasis; in fact, a study published in 2018 [20] showed that these patients, especially in presence of eo-sinophilic inflammation, have higher levels of FeNO and a higher reversibility to the bronchodilator test respect to bronchiectasis patients with a prevalent neutrophilic inflammation (lower levels of FeNO and poor reversibility). Several trials showed that FeNO levels in asthmatic patients are related with the upper airways' inflammation, the bronchial reactivity, the disease severity, and the presence of eosinophilia [63][64][65][66][67][68][69].…”

Section: Nitric Oxidementioning

confidence: 99%

“…Several trials showed that FeNO levels in asthmatic patients are related with the upper airways' inflammation, the bronchial reactivity, the disease severity, and the presence of eosinophilia [63][64][65][66][67][68][69]. On the contrary, the role of FeNO in patients with bronchiectasis is debated; in fact, some studies showed that FeNO levels are related to the severity of bronchiectasis [70], thus others showed that FeNO levels are low and in particular lower than those observed in asthmatic patients [20]. A recently published study [53] tried to clarify this problem, emphasizing that FeNO and interleukin-13 (IL-13) levels and reversibility to bronchodilation are higher in patients with bronchiectasis and concomitant eosinophilic inflammation (or a mixed eosinophilic-neutrophilic inflammation), as observed in asthmatic patients.…”

Section: Nitric Oxidementioning

confidence: 99%

The Link between Asthma and Bronchiectasis: State of the Art

et al. 2020

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The nonrecognition of asthma-associated comorbidities is often responsible for the therapeutic failure and the worsening of symptoms, and it is associated with frequent exacerbations, higher disease severity, and increased health costs. Bronchiectasis, one of the most frequent asthma-associated comorbidities, can increase airways inflammation and exacerbation rates and cause respiratory functional impairment. The aim of this article is to review the interactions between bronchiectasis and asthma, in order to better identify patients in the overlap between the 2 diseases and to select an "ad hoc" therapy. A literature search on PubMed/MEDLINE was performed using the following search terms: bronchiectasis in asthma, the association between asthma and bronchiectasis, comorbidities in asthma, and severe asthma. This review analyzed the following items: incorrect or underestimated diagnosis of asthma and bronchiectasis, prevalence of bronchiectasis in asthma, the impact of bronchiectasis in asthma, radiological imaging features of the 2 diseases, etiopathogenesis, and common causes (such as gastroesopha-geal reflux disease, immune deficits, chronic rhinosinusitis and allergic bronchopulmonary aspergillosis, and treatment of asthma and bronchiectasis). The concomitant presence of bronchiectasis and asthma should be suspected and investigated in patients with severe asthma, frequent exacerbations, and not responding to standard therapy. This clinical phenotype, characterized by a more severe disease, worse outcomes, and functional decline, must be readily recognized in order to choose the most appropriate therapeutic approach, able to potentially improve the management of bronchial asthma, to prevent the onset of exacerbations as well the functional decline, and to reduce health costs.

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“…A 28.4% prevalence of bronchiectasis reported in uncontrolled moderate-to-severe asthma (2), means that one in three asthma patients experiences this type of association. Previous studies revealed that the association is related to the severity of asthma, the presence of chronic expectoration, lower levels of fractional exhaled nitric oxide (Fe NO), and a previous history of pneumonia (3). In the literature, the prevalence of bronchiectasis among patients with asthma ranges from 2.2% (4) to 77% (5).…”

Section: Editorialmentioning

confidence: 99%