Steroid insensitive fixed airflow obstruction is not related to airway inflammation in older non-smokers with asthma

K O Tonga; G G King; C S Farah; C Thamrin; F S Tang; J Santos; P Sharma; D G Chapman; B G Oliver

doi:10.1186/s12931-018-0880-2

Steroid insensitive fixed airflow obstruction is not related to airway inflammation in older non-smokers with asthma

Respir Res. 2018 Sep 17;19(1):176. doi: 10.1186/s12931-018-0880-2.

Authors

K O Tonga^{1

2

3

4

5}, G G King^{6

7

8}, C S Farah^{6

9

8

10}, C Thamrin^{6

8}, F S Tang⁶, J Santos^{11

12

13}, P Sharma^{6

11

12}, D G Chapman^{6

11

12}, B G Oliver^{6

11

12}

Affiliations

¹ Woolcock Institute of Medical Research, The University of Sydney, Glebe New South Wales, Sydney, NSW, 2037, Australia. [email protected].
² Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia. [email protected].
³ Department of Respiratory Medicine, Concord Hospital, Concord, NSW, Australia. [email protected].
⁴ The University of Sydney, School of Medicine, Faculty of Medicine and Health, Sydney, NSW, Australia. [email protected].
⁵ St Vincent's Clinical School, University of New South Wales Medicine, University of New South Wales, Darlinghurst, NSW, Australia. [email protected].
⁶ Woolcock Institute of Medical Research, The University of Sydney, Glebe New South Wales, Sydney, NSW, 2037, Australia.
⁷ Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia.
⁸ The University of Sydney, School of Medicine, Faculty of Medicine and Health, Sydney, NSW, Australia.
⁹ Department of Respiratory Medicine, Concord Hospital, Concord, NSW, Australia.
¹⁰ Macquarie University, Faculty of Medicine and Health Sciences, North Ryde, NSW, Australia.
¹¹ Discipline of Medical Sciences, University of Technology Sydney, Broadway, Sydney, NSW, Australia.
¹² School of Life Sciences, University of Technology Sydney, Ultimo, NSW, Australia.
¹³ CIRIMAT, University of Toulouse, Toulouse, France.

Abstract

There is limited evidence linking airway inflammation and lung function impairment in older non-smoking asthmatics with fixed airflow obstruction (FAO), which can develop despite treatment with inhaled corticosteroids (ICS). We assessed lung function (spirometry, forced oscillation technique (FOT)), lung elastic recoil and airway inflammation using bronchoalveolar lavage (BAL) in non-smoking adult asthmatics with FAO, following 2 months treatment with high-dose ICS/long-acting beta-agonist. Subjects demonstrated moderate FAO, abnormal FOT indices and loss of lung elastic recoil. This cross-sectional study showed a lack of a relationship between BAL neutrophils, eosinophils, inflammatory cytokines and lung function impairment. Other inflammatory pathways or the effect of inflammation on lung function over time may explain FAO development.

Keywords: Airway inflammation; Asthma; Fixed airflow obstruction; Reduced lung elastic recoil.

Publication types

Letter

MeSH terms

Adrenal Cortex Hormones / pharmacology
Adrenal Cortex Hormones / therapeutic use*
Aged
Asthma / diagnosis
Asthma / drug therapy*
Asthma / physiopathology*
Bronchoalveolar Lavage Fluid
Cohort Studies
Cross-Sectional Studies
Female
Forced Expiratory Volume / drug effects
Forced Expiratory Volume / physiology
Humans
Inflammation / diagnosis
Inflammation / drug therapy
Inflammation / physiopathology
Male
Middle Aged
Non-Smokers*
Prospective Studies
Pulmonary Disease, Chronic Obstructive / diagnosis
Pulmonary Disease, Chronic Obstructive / drug therapy*
Pulmonary Disease, Chronic Obstructive / physiopathology*
Respiratory Function Tests / methods
Spirometry / methods

Substances

Adrenal Cortex Hormones