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Published on: November 4, 2010
Risk factors related to fixed airway obstruction in patients with asthma after antiasthma treatment
An-Soo Jang1, June-Hyuk Lee, Sung Woo Park
1Asthma and Allergy Research Group, Division of Allergy and Respiratory Diseases, Soonchunhyang University Hospital, Bucheon, Republic of Korea.
Background:
There are many unanswered questions about the role of airway remodeling in asthma.
Objective:
To evaluate the physiologic factors related to airway remodeling after antiasthma drug treatment for 1 year.
Methods:
We gave 582 patients with asthma long-term control medication for 1 year according to the severity of their asthma. Airway remodeling was defined using forced expiratory volume in 1 second/forced vital capacity and a predicted forced expiratory volume in 1 second of less than 75% after antiasthma treatment.
Results:
Of the 582 patients, 49 (8.4%) had airway remodeling. Severe asthma resulted in more airway remodeling than mild-to-moderate asthma. Asthmatic patients with airway remodeling were significantly older and had a longer duration of asthma. Asthmatic patients with airway remodeling had more emphysema on high-resolution computed tomography, a higher rate of near-fatal asthma attacks, a lower percentage of sputum eosinophils, a lower atopy frequency, a greater response to short-acting bronchodilators, and a lower body mass index (BMI) than those without airway remodeling. Age, asthma duration, and BMI were important discriminators of airway remodeling.
Conclusion:
Nonatopy, asthma duration, emphysema on high-resolution computed tomography, sputum eosinophils, age, and BMI before antiasthma treatment are important factors related to airway remodeling in patients with asthma.
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