Persistent airway obstruction after virus infection is not associated with airway inflammation

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1、OriginalResearchASTHMAPersistentAirwayObstructionAfterVirusInfectionIsNotAssociatedWithAirwayInflammation*LisaG.Wood,PhD;HeatherPowell,MMedSci;TerryGrissell,BSc;ThuyT.D.Nguyen,MD;DarrenShafren,PhD;MichaelHensley,MBBS;andPeterG.Gibson,MBBSBackground:Thisstudyexaminedthecontributionofairwa

2、yinflammationtothedelayedlungfunctionrecoverythatoccursinsomepeoplefollowingvirus-inducedasthmaexacerbations.Methods:Subjects(n
40)wererecruitedathospitaladmissionforacuteasthmaexacerbation.Respiratoryvirusinfectionwasdiagnosedbyviralnucleicaciddetectionand/orcellculture,usinginducedsput

3、um,nasal,orthroatswabs.Datacollectedincludedlungfunction,answerstocommoncoldandasthmacontrolquestionnaires,andinducedsputumcellularprofiles.Subjectswerereexamined4to6weekspostexacerbationandwerecomparedwithstableasthmaticsubjects(n
26)whohadbeenrecruitedfromambulatorycareclinics.Results:

4、Persistentairwayobstruction,definedaslungfunctionimprovementatfollow-up(ie,changeinFEV1percentpredicted[%FEV1])of<15%,wasobservedin10subjects(25%).Airwayrecovery(%FEV1,>15%)wasobservedintheremainingsubjects(30subjects;75%).Duringtheacuteepisode,theairway-recoverygrouphadincreasedtotalc

5、ellcount(p
0.019),increasednumberofneutrophils(p
0.005),andincreasedpercentageofneutrophils(p
0.0043)comparedtothegroupofstablesubjectswithasthma.Postexacerbation,theairway-recoverygrouphadreducednumbersofneutrophilsandanincreasedpercentageofeosinophils.Incontrast,duringexacerbation,subj

6、ectswithpersistentairwayobstructionshowednodifferencesininflammatorycellcountscomparedtostablesubjectswithasthma,nordidcellcountschangepostexacerbation.Symptomsimprovedinbothgroupspostexacerbation.However,inthepersistent–airway-obstructiongroup,asthmaremaineduncontrolled.Conclusion:Persi

7、stentairwayobstructionanduncontrolledasthmaareobservedinsomepeopleafterviralasthmaexacerbations.Theseabnormalitiesarenotassociatedwithinflammatorycellinfluxintotheairwayliningfluidduringtheexacerbationandmayreflecttheinvolvementofnoncellularelements.Furtherworkshouldexplo