Smoking, longer disease duration and absence of rhinosinusitis are related to fixed airway obstruction in Koreans with severe asthma: findings from the COREA study

Abstract

BackgroundThe clinical manifestations of severe asthma are heterogeneous. Some individuals with severe asthma develop irreversible fixed airway obstruction, which is associated with poor outcomes. We therefore investigated the factors associated with fixed airway obstruction in Korean patients with severe asthma.MethodsSevere asthma patients from a Korean adult asthma cohort were divided into two groups according to the results of serial pulmonary function tests. One group had fixed airway obstruction (FAO) [forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio < 0.7, n = 119] and the other had reversible airway obstruction (RAO) [FEV1/FVC ratio ≥ 0.7, n = 116]. Clinical and demographic parameters were compared between the two groups.ResultsMultivariate analysis showed that longer duration of disease, greater amount of cigarette smoking and absence of rhinosinusitis were significantly related to the development of FAO in severe asthmatics. Other parameters, including atopic status, pattern of airway inflammatory cells in induced sputum, and frequency of asthma exacerbations did not differ between the FAO and RAO groups.ConclusionSevere asthma patients with longer disease duration and the absence of rhinosinusitis are more likely to develop FAO. This study also demonstrates the importance of quitting smoking in order to prevent irreversible airway obstruction. Further investigation is required to determine the mechanism by which these factors can modify the disease course in Korean patients with severe asthma.

Risk Factors for Asthma-Related Healthcare Use: Longitudinal Analysis Using the NHI Claims Database in a Korean Asthma Cohort

“…In this study, the data of 736 patients from the COREA (COhort for Reality and Evolution of adult Asthma in Korea) cohort [13] , [14] (See Methods and Results S1 ) registered between January 2006 and December 2007 were linked to the NHI claims database. Each individual’s clinical information from the COREA cohort and the asthma-related healthcare use from the claims data were thoroughly investigated for a duration of 3 consecutive years from the time of the COREA enrollment, which was considered the index period.…”

“…Airway reversibility referred to the status of improvement of airway obstruction after asthma treatment, divided into two categories: fixed airway obstruction (FAO) and reversible airway obstruction (RAO). [14] FAO was defined as an FEV 1 (Forced expiratory volume in one second)/functional volume capacity (FVC) ratio <70% on all pulmonary function tests for the first 12 months despite the use of high-dose ICS/LABA. RAO was defined when an FEV 1 /FVC ratio >70% was shown on at least one pulmonary function test during the index period.…”

Large Porous Hollow Particles: Lightweight Champions of Pulmonary Drug Delivery

“…Repeated administration of inhaled heparin gave a stable pharmacokinetic performance in terms of t max , C max and bioavailability, and did not result in any observable side effects [53]. It is important to note that while their results are promising, the safety in use of chemicals that alter tight junctions is a concern as alteration of tight junctions has been associated with progressive lung disease [55, 56]. Patel et al investigated heparin-loaded large porous particles made of polyethylene glycol - poly(lactide-co-glycolide) (PEG-PLGA) for improved heparin delivery by pulmonary route.…”

Exercise training alone or with the addition of activity counseling improves physical activity levels in COPD: a systematic review and meta-analysis of randomized controlled trials

“…A systematic review comparing activity levels in COPD patients with age-matched controls showed a marked reduction in activity duration, intensity and daily step counts, regardless of disease severity 3. Physical activity (PA) levels are strongly correlated with functional exercise capacity 4.…”