Will Nonasthmatic Eosinophilic Bronchitis Develop Into Chronic Airway Obstruction?

Lai, Kefang; Liu, Baojuan; Xu, Danyuan; Han, Lina; Lin, Ling; Xi, Yin; Wang, Fa-xia; Chen, Ruchong; Luo, Wei; Chen, Qiaoli; Zhong, Nanshan

doi:10.1378/chest.14-2351

Cited by 36 publications

(34 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recently, Lai and colleagues [23] suggested that persistence of eosinophilic inflammation invariably does not lead to rapid lung function decline and that this perhaps requires other features of susceptibility to disease progression, such as concomitant features of airway remodeling and changes in airway morphometry. Eltboli and colleagues [24] reported that there is a strong correlation between peripheral blood and bronchial eosinophils and reticular basement membrane thickening and suggested that the peripheral blood eosinophil count does identify COPD subjects with a greater tissue eosinophilia.…”

Section: Discussionmentioning

confidence: 99%

The Time Course of Pulmonary Function Tests in COPD Patients with Different Levels of Blood Eosinophils

Rogliani

Puxeddu

Ciaprini

et al. 2016

BioMed Research International

View full text Add to dashboard Cite

Only very few studies have investigated the influence of eosinophils on the functional progression of COPD. We aimed at retrospectively analyzing the trend of pulmonary function tests over time in patients with COPD according to two baseline blood eosinophil cell count strata (<2% [EOS−] and ≥2% [EOS+]). We used the last 9-year data present in the database of our outpatient clinic and selected only those who had two blood counts that would guarantee the stability of the value of eosinophils and serial spirometry for 4 consecutive years. The analysis of the time course of the spirometric variables analysed showed differences in FEV1 and FVC decline between the subjects of the EOS− group and those of the EOS+ group. The integrated evaluation of our results suggests that the different level of blood eosinophils in the two groups may have influenced independently the time course of the pulmonary function tests and identify two subgroups of subjects with specific disease characteristics: the hyperinflator and the rapid decliner, respectively.

show abstract

Section: Discussionmentioning

confidence: 99%

The Time Course of Pulmonary Function Tests in COPD Patients with Different Levels of Blood Eosinophils

Rogliani

Puxeddu

Ciaprini

et al. 2016

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…In , 46% of the participants were smokers. However, only 6% of NAEB patients were smokers in the study by Lai et al 7 .…”

Section: Discussionmentioning

confidence: 88%

“…According to previous studies by Berry et al 5 and Park et al 6 , persistent airflow obstruction developed in approximately 15% of NAEB patients. However, in a recent investigation by Lai et al 7 , none of the NAEB patients developed persistent airflow obstruction. This inconsistency regarding COPD development may have arisen because the studies had different proportions of smokers.…”

Section: Discussionmentioning

confidence: 89%

“…However, these patients lack evidence of variable airflow limitation or airway hyperresponsiveness. Previous longitudinal studies on NAEB have focused on the prognosis concerning relapse and the development of chronic airflow obstruction [5][6][7] . However, NAEB patients could have respiratory symptoms other than cough, such as chest tightness with wheezing, shortness of breath, and sputum production [8][9][10] , and treatment with systemic corticosteroids is occasionally required to relieve these symptoms 11 .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Clinical outcome of eosinophilic airway inflammation in chronic airway diseases including nonasthmatic eosinophilic bronchitis

Cho

Choi

Lee

et al. 2017

Allergy and Immunology

View full text Add to dashboard Cite

We enrolled patients with confirmed sputum eosinophilia who had visited our tertiary referral hospital between 2012 and 2015. We evaluated the incidence and predictors of exacerbations in patients with nonasthmatic eosinophilic bronchitis (NAEB), and investigated predictors of improvement in eosinophilic inflammation in chronic airway diseases with or without persistent airflow limitation. In total, 398 patients with sputum eosinophilia were enrolled. Of these, 152 (38.2%) had NAEB. The incidence rate of exacerbations requiring treatment with antibiotics, systemic corticosteroids, or hospital admission was 0.13 per patient-year (95% CI, 0.06-0.19) in NAEB. Inhaled corticosteroid (ICS) did not affect the risk of exacerbations, even in an analysis of propensity score. One hundred seventysix patients had chronic airway diseases; in 37 of these (21.0%), sputum eosinophilia had improved at the 1-year follow-up. Patients who had persistent airflow limitation were less likely to show an improvement in eosinophilic inflammation (aOR, 0.26; 95% CI, 0.09-0.77) when they were treated with ICSs for less than 75% of the follow-up days. Exacerbations requiring systemic corticosteroids, antibiotics, or hospitalization did occur, although infrequently, in NAEB patients. Among patients with chronic airway diseases, those with persistent airflow limitation were less likely to show an improvement in eosinophilic airway inflammation.Nonasthmatic eosinophilic bronchitis (NAEB) usually presents with corticosteroid-responsive chronic cough; in fact, the condition is diagnosed in 13% to 33% of patients with chronic cough referred for specialist opinion [1][2][3][4] . Patients with NAEB have eosinophilic airway inflammation, which manifests as sputum eosinophilia similar to that in asthma. However, these patients lack evidence of variable airflow limitation or airway hyperresponsiveness. Previous longitudinal studies on NAEB have focused on the prognosis concerning relapse and the development of chronic airflow obstruction [5][6][7] . However, NAEB patients could have respiratory symptoms other than cough, such as chest tightness with wheezing, shortness of breath, and sputum production [8][9][10] , and treatment with systemic corticosteroids is occasionally required to relieve these symptoms 11 . No studies have yet investigated the incidence and predictors of acute exacerbations, defined as worsened respiratory symptoms requiring systemic treatment, in this condition.Sputum eosinophilia is also present in 38% to 44% of patients with persistent airflow limitation, including those with chronic obstructive pulmonary disease (COPD) 12,13 . Patients with COPD who show eosinophilic airway inflammation respond better to inhaled corticosteroids (ICSs) 12,14 and systemic corticosteroids 13,15 , as do those with asthma-COPD overlap syndrome (ACOS) 16 . However, it is not yet clear whether the outcome of eosinophilic airway inflammation differs depending on whether persistent airflow limitation-a characteristic of COPD-is present.

show abstract

“…However, 3 of 32 patients (9%) followed up for at least 1 year with the diagnosis of NAEB were observed to have asthma with typical symptoms and airway hypersensitivity, 5 (16%) of them had fixed airway obstruction, and symptoms and/ or airway inflammation persisted in 21 (66% ) of them [20]. In the study of Lai et al [42], 234 patients were identified to have NAEB and 141 of them were followed up for more than 1 year. Up to 59.6% of the patients had recurrence after treatment.…”

Section: The Natural Course Of Non-asthmatic Eosinophilic Bronchitismentioning

confidence: 97%

Non-astmatic Eosinophilic Bronchitis

Yıldız

Dülger

2018

Turk Thorac J

View full text Add to dashboard Cite

Non-asthmatic eosinophilic bronchitis (NAEB) is a chronic disease and was first described in a small group of patients by Gibson et al. [1,2] in a relatively recent date. Without bronchospasm, it is defined as eosinophilic inflammation of the respiratory tract and is usually associated with eosinophilia in sputum. It is one of the most important causes of chronic cough [3].When a cough lasting longer than 8 weeks is detected in clinical practice; if chest X-ray is normal, this situation is defined as chronic cough. Chronic cough is a common cause of complaints all over the world, especially at the centers giving outpatient care, and is responsible for about 40% of the applications [4][5][6]. However, the cause(s) leading to this condition can be detected in 75-90% [7][8][9]. NAEB is a disease that should be remembered in the differential diagnosis of chronic cough but it is often ignored [10]. Because the systematic examination of bronchial inflammation can be made rarely, it is probably diagnosed less than it exists [11]. When the other causes that may lead to chronic cough are eliminated in patients applying with the complaint of chronic cough, NAEB should be taken into consideration [12][13][14][15][16][17][18][19].The purpose of this article is to make it possible to consider the differential diagnosis of patients with chronic cough by drawing attention to NAEB, and to compile and present the literature data that is relatively limited. ETIOLOGYAlthough the etiology of NAEB is not clear yet, environmental or occupational factors may be responsible for this situation in some of the patients. In a significant proportion of the diagnosed patients, occupational dust exposure was considered to be possibly etiologically responsible. For this reason, the possibility of occupation-related causes should be considered in patients with chronic cough due to NAEB [20]. Especially resin hardener, welding fume and formaldehyde exposures have been shown to lead to NAEB [21][22][23][24]. Non-asthmatic eosinophilic bronchitis (NAEB) is eosinophilic inflammation of the respiratory tract, without any bronchospasm. In this article, we want to draw attention to the NAEB. It should also be considered in differential diagnosis of chronic cough. Eosinophilia is present in all induced or spontaneous sputum samples of NAEB patients. NAEB patients and asthmatic patients have similar airway inflammation. Remarkably, NAEB mainly occurs in the lower airways. Unlike asthma, mast cells in NAEB are active in the bronchial epithelium. Diagnosis is based on the clinical, radiological, and spirometric measurements of other causes of chronic cough (Post-nasal discharge syndrome, asthma, gastroesophageal reflux etc.) and the assessment of inflammation in the lower respiratory tract. Airway inflammation can be assessed by sputum induction. The main treatment is anti-inflammatory therapy with inhaled corticosteroids and taking protective measures if inflammation is due to occupational exposure or allergen inhalation. If NAEB is untreated, it may be ...

show abstract

Will Nonasthmatic Eosinophilic Bronchitis Develop Into Chronic Airway Obstruction?

Cited by 36 publications

References 34 publications

The Time Course of Pulmonary Function Tests in COPD Patients with Different Levels of Blood Eosinophils

The Time Course of Pulmonary Function Tests in COPD Patients with Different Levels of Blood Eosinophils

Clinical outcome of eosinophilic airway inflammation in chronic airway diseases including nonasthmatic eosinophilic bronchitis

Non-astmatic Eosinophilic Bronchitis

Contact Info

Product

Resources

About