Prevalence of bronchiectasis in asthma according to oral steroid requirement: influence of immunoglobulin levels.

Biomed Res Int

Servei de Pneumologia, Hospital de Sabadell, Corporació Sanitària i Universitària Parc Taulí, Parc Taulí 1, Sabadell, 08208 Barcelona, Spain ; Departament de Medicina, Universitat Autònoma de Barcelona (UAB), Campus de la UAB, Cerdanyola del Vallès, 08193 Barcelona, Spain ; Ciber de Enfermedades Respiratorias (CIBERES), Carretera Soller Km 12, Illes Balears, 07110 Bunyola, Spain.

Published: July 2014

Purpose: To establish the prevalence of bronchiectasis in asthma in relation to patients' oral corticosteroid requirements and to explore whether the increased risk is due to blood immunoglobulin (Ig) concentration.

Methods: Case-control cross-sectional study, including 100 sex- and age-matched patients, 50 with non-steroid-dependent asthma (NSDA) and 50 with steroid-dependent asthma (SDA).

Study Protocol: (a) measurement of Ig and gG subclass concentration; (b) forced spirometry; and (c) high-resolution thoracic computed tomography. When bronchiectasis was detected, a specific etiological protocol was applied to establish its etiology.

Results: The overall prevalence of bronchiectasis was 12/50 in the SDA group and 6/50 in the NSDA group (p = ns). The etiology was documented in six patients (four NSDA and two SDA). After excluding these patients, the prevalence of bronchiectasis was 20% (10/50) in the SDA group and 2/50 (4%) in the NSDA group (P < 0.05). Patients with asthma-associated bronchiectasis presented lower FEV1 values than patients without bronchiectasis, but the levels of Ig and subclasses of IgG did not present differences.

Conclusions: Steroid-dependent asthma seems to be associated with a greater risk of developing bronchiectasis than non-steroid-dependent asthma. This is probably due to the disease itself rather than to other influencing factors such as immunoglobulin levels.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3845843PMC
http://dx.doi.org/10.1155/2013/109219DOI Listing

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