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Small Airways Dysfunction and Bronchial Hyper-Responsiveness in Cough Variant Asthma.
Jie Gao1, Hai Gui Wu1, Feng Wu1
1Department of Pulmonary and Critical Care Medicine, Huizhou the Third People's Hospital, Guangzhou Medical College, Huizhou 516002, People's Republic of China.
International Journal of General Medicine
|December 16, 2020
Summary
Cough variant asthma (CVA) shows milder small airway dysfunction compared to classic asthma (CA). While bronchial hyper-responsiveness (BHR) and small airway measures correlate with CVA, they are not yet clinically useful for diagnosis.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Asthma Research
Background:
- Cough variant asthma (CVA) represents an atypical presentation of asthma.
- Distinguishing CVA from classic asthma (CA) is crucial for appropriate management.
- Understanding the differences in small airway function and bronchial hyper-responsiveness (BHR) is key.
Purpose of the Study:
- To compare spirometric parameters of small airways between CVA and CA patients.
- To evaluate the degree of BHR in CVA versus CA.
- To determine the relationship between BHR and small airways in CVA and assess their diagnostic accuracy.
Main Methods:
- A cohort of 614 asthma patients (out of 825 screened) underwent spirometry.
- All participants were subjected to a bronchial challenge test using methacholine.
- Analysis focused on comparing small airway function metrics and BHR between CVA and CA groups.
Main Results:
- CVA patients exhibited less small airway dysfunction compared to CA patients, evidenced by lower MMEF% predicted (70% vs 80.91%) and FEF50% predicted (62.71% vs 73.5%).
- Significant positive correlations were found between BHR measures (PD20) and small airway function parameters (MMEF, FEF50, FEF75) in CVA.
- The best diagnostic value for CVA using PD20 yielded an AUC of 0.582, indicating limited clinical utility.
Conclusions:
- Small airway dysfunction is less severe in CVA compared to CA.
- While BHR and small airway parameters show a significant relationship with CVA, their combined predictive value is not sufficient for clinical application.
- Further research may be needed to identify more accurate diagnostic markers for CVA.
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