Specific Asthmatic Phenotype of Patients with Bronchiectasis in Ukraine

Suska, K. and Gashynova, K. and Dmytrychenko, V. (2021) Specific Asthmatic Phenotype of Patients with Bronchiectasis in Ukraine. American Journal of Respiratory and Critical Care Medicine, 203. A2014. ISSN 1073-449X (Print); 1535-4970 (Online)

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Abstract

Background. Bronchiectasis (Bx) is a chronic inflammatory airways disease with high rate of comorbidity andheterogeneity of clinical and laboratory characteristics. The aim: to detect if there are features of the course ofthe disease in patients with Bx and comorbid asthma. Materials and methods. Stable bronchiectasis patientsconfirmed by HRCT were included. Asthma was diagnosed based on GINA recommendations. Bx exacerbationsfrequency during the previous year was calculated by self-reports and medical documentation analyzing.Allergen-specific IgG4 to recombinant (rAspf1) Aspergillus fumigatus (AF) allergens (AfIgG4) was measured withThermo Fisher ImmunoCAP. Total serum IgE (TSIgE) was evaluated by electrochemiluminescence immunoassay,specific IgE to AF (sIgEAf) was measured by immunoCAP technology. Microbiological detection of sputumsamples was conducted by bacteriological methods. Results. 80 patients (28 (35%) men) made the studysample. The average age 53.2 (13.9) years. 14 patients had asthma (17.5%). Patients were divided in twogroups: G1 - with asthma, G2 - without asthma. There were not statistically significant differences between thegroups in age and sex. The median number of exacerbations in G1 was 4 (3;7.5) per year, G2 - 2 (1;4), p=0.001by Mann-Whitney test. The number of frequent exacerbators (3 and more per year) in G1 was 13(92.8%), G2 -25(37.8%), p=0.0001 by xi-square test. The median TSIgE in G1 - 268.7(42.5;410) ME/ml, G2 - 48.5(19.2;120.6)ME/ml, p=0.04. The median AfIgG4 in G1 - 0.19(0.12;0.24) kU/L, G2 - 0.08(0.03;0.11) kU/L, p=0.04. In turn, themedian sIgEAf in G1 - 0.1(0.1;0.1) kU/L, G2 - 0.1(0.1;0.1) kU/L, p=0.97. The number of patients with sputumchronically colonized by pathogens in G1 - 6(42.8%), G2 - 39(59.1%), p=0.03. Pseudomonas aeruginosa (PA)was detected in G1 in 3 patients (21.4%), G2 - in 14(21.2%) patients, p=0.87. Conclusions. 17.5% patients withBx have asthma in Dnipro region. This phenotype has more frequent exacerbations and a higher proportion offrequent exacerbators although the number of patients with PA colonization did not differ between groups.TSIgE was predictably higher in patients with Bx and comorbid asthma. The measurement of sIgEAf did notshow statistically significant differences in the presence of hypersensitization to AF, but the determination ofAfIgG4 indicated chronic contact, although there was not detected any AF positive sample during bacteriologicalanalyses. This response was higher in patients with asthma. Based on this data, we recommend furtherinvestigations of the sAfIgG4 level in all patients with Bx focusing on patients with comorbid asthma.

Item Type:	Article
Uncontrolled Keywords:	bronchiectasis, asthma
Subjects:	Pulmonology
Divisions:	Departments > Department of occupational diseases, clinical immunology and clinical pharmacology
Depositing User:	Елена Шрамко
Date Deposited:	18 Nov 2021 08:18
Last Modified:	18 Nov 2021 08:18
URI:	http://repo.dma.dp.ua/id/eprint/7131

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