Tracheal section is an independent predictor of asthma in patients with nasal polyposis

Bokov, Plamen; Chevalier-Bidaud, Brigitte; Dandachi, Ghanima Al; Londner, Cécile; Plantier, Laurent; Bonfils, P.; Delclaux, Christophe

doi:10.1016/j.resp.2014.08.017

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…One may hypothesise that pre-existing lung anatomy constitutes a risk factor for COPD and asthma, an argument for their early origin. Along this line, we recently showed that airway anatomy, crudely assessed by tracheal section, is an independent predictor of asthma 3. Thus, a reduced tracheal section, as observed in this study in COPD, leads to a reduction of the lumen areas of the whole bronchial tree for a given homothety factor.…”

supporting

confidence: 72%

Airway anatomy as a risk factor of COPD

Bokov

Delclaux

2014

Thorax

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supporting

confidence: 72%

Airway anatomy as a risk factor of COPD

Bokov

Delclaux

2014

Thorax

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“…The absence of a significant association between baseline proximal airway volume and airway responsiveness in the present study is consistent with our previous observation that tracheal volume is not associated with airway responsiveness in patients with nasal polyposis [ 35 ], and suggests that interindividual variation in the baseline volume of large airways is not an important determinant of BHR. This result contrasts with the known association between BHR and low forced expiratory flows at low lung volume, and in particular the FEF 25-75 /FVC ratio, which was interpreted as an indication for the involvement of anatomical variation of small airways in BHR [ 36 ].…”

Section: Discussionsupporting

confidence: 93%

“…This discrepancy suggests that proximal and distal airway sizes may not be strongly correlated in patients with respiratory symptoms. Based on theoretical grounds, the progressive reduction of airway calibre at each generation can be described by a single constant factor, the homothety ratio, due to the fractal nature of the bronchial tree [ 35 ]. Thus, one may hypothesize that patients with BHR could have a reduced homothety ratio, which would not impact the volume of proximal airways but would increase the propensity for distal airflow limitation to occur.…”

Section: Discussionmentioning

confidence: 99%

Methacholine-Induced Variations in Airway Volume and the Slope of the Alveolar Capnogram Are Distinctly Associated with Airflow Limitation and Airway Closure

et al. 2015

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Mechanisms driving alteration of lung function in response to inhalation of a methacholine aerosol are incompletely understood. To explore to what extent large and small airways contribute to airflow limitation and airway closure in this context, volumetric capnography was performed before (n = 93) and after (n = 78) methacholine provocation in subjects with an intermediate clinical probability of asthma. Anatomical dead space (VDaw), reflecting large airway volume, and the slope of the alveolar capnogram (slope3), an index of ventilation heterogeneity linked to small airway dysfunction, were determined. At baseline, VDaw was positively correlated with lung volumes, FEV1 and peak expiratory flow, while slope3 was not correlated with any lung function index. Variations in VDaw and slope3 following methacholine stimulation were correlated to a small degree (R2 = -0.20). Multivariate regression analysis identified independent associations between variation in FEV1 and variations in both VDaw (Standardized Coefficient-SC = 0.66) and Slope3 (SC = 0.35). By contrast, variation in FVC was strongly associated with variations in VDaw (SC = 0.8) but not Slope3. Thus, alterations in the geometry and/or function of large and small airways were weakly correlated and contributed distinctly to airflow limitation. While both large and small airways contributed to airflow limitation as assessed by FEV1, airway closure as assessed by FVC reduction mostly involved the large airways.

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“…Indeed, more than 60% of undiagnosed asthmatic patients with NPs have some level of lower airway involvement (76,77) , especially in patients with eosinophilic subtypes of nasal polyps (78,79) . After evaluation of bronchial hyperresponsiveness (BHR) in adult patients with NPs, approximately 28% to 40% patients with NPs had newly diagnosed asthma (77,(80)(81)(82)(83) , indicating that asthma might coexist as a subclinical disease in NPs.…”

Section: Development Of Nasal Polyps and Comorbid Asthma: Epidemiology And Disease Coursementioning

confidence: 99%

Progression from nasal polyps to adult-onset asthma: a different process from atopic march?

Wu¹,

Bleier²,

Wei³

2018

RHINOL

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Nasal polyps and comorbid asthma (NPcA) is a severe clinical entity, which is often treated as a united airway disease. Asthma is frequently associated with allergic rhinitis and nasal polyps and the natural course of asthma has long been explored. The "atopic march" has been proposed for decades to explain the progression of the united airway diseases. The atopic march principally relates to the development of childhood asthma from atopic conditions. In contrast, adult-onset asthma, which is often non-atopic and more severe, has been shown to be highly associated with nasal polyps. Recently, asthma onset pattern and its association with upper airway diseases have gained increasing attention, which is partly due to the different phenotypes of asthma with respect to comorbidity, disease severity, and treatment responses. Despite extensive research over the past years, the progression of asthma from upper airway diseases remain incompletely defined. This review compares the natural course of childhood and adult-onset asthma and highlights the distinct progression of NPcA. Additionally, risk factors, mechanisms and potential targets of NPcA are also summarized. Advancements in understanding the natural course and pathogenic mechanisms of NPcA may guide the effective therapeutic strategies or possibly curb the progression of NPcA.

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Tracheal section is an independent predictor of asthma in patients with nasal polyposis

Cited by 5 publications

References 27 publications

Airway anatomy as a risk factor of COPD

Airway anatomy as a risk factor of COPD

Methacholine-Induced Variations in Airway Volume and the Slope of the Alveolar Capnogram Are Distinctly Associated with Airflow Limitation and Airway Closure

Progression from nasal polyps to adult-onset asthma: a different process from atopic march?

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