A new modified classification of bronchial asthma based on clinical symptoms

The clinical features of four asthma types, Ia-1 (bronchospasm with 0-49 ml/day of expectoration), Ia-2 (with 50-99 ml/day), Ib (over 100 ml/day), and II (bronchiolar obstruction), as classified by the clinical symptoms, were compared in 119 patients with bronchial asthma. The age of onset characteristic symptoms of each asthma type was in the 20's in types Ia-1 and Ia-2, in the 30's in type Ib, and in the 40's in type II patients. A significant increase in the number of neutrophils in bronchoalveolar lavage (BAL) fluid was found in type II patients. The proportion of BAL eosinophils was significantly higher in types Ia-2 and Ib asthma patients compared with that in type Ia-1 patients. The BAL eosinophil count was significantly higher in type Ib than in type Ia-2 patients. The FEV1.0% and %V25 values were significantly lower in patients with type II asthma than in the patients with the other asthma types. Steroid-dependent intractable asthma (SDIA) was more often observed in patients with type Ib or type II asthma.