Clinical and histological comparison of smoking and non-smoking patients with severe asthma in the U-BIOPRED cohort
P. P. W. Hekking, S. J. Wilson, A. H. Wagener, A. R. Sousa, J. Corfield, D. E. Shaw, S. J. Fowler, L. J. Fleming, J. H. Riley, E. Jeyasingham, A. Rowe, W. Seibold, G. Roberts, P. Bakke, F. Singer, T. Geiser, U. Frey, I. Horvath, R. Polosa, N. Krug, J. Musial, L. Pahus, D. Myles, C. Compton, T. W. Higenbottam, P. Montuschi, U. Nihlén, T. Sandstrom, S. S. Wagers, P. H. Howarth, R. Djukanovic, K. F. Chung, I. Pandis, Y. Guo, A. T. Bansal, E. H. Bel, P. J. Sterk (Amsterdam, Netherlands; Southampton, London, Nottingham, Manchester, Horsham, Cambridge, United Kingdom; Biberach an der Riss, Hannover, Germany; Bergen, Norway; Bern, Switzerland; Budapest, Hungary; Catania, Rome, Italy; Stockholm, Umea, Sweden; Marseille, France; Maasmechelen, Belgium; Krakow, Poland)
Source: International Congress 2014 – Phenotyping and monitoring asthma and COPD
Session: Phenotyping and monitoring asthma and COPD
Session type: Oral Presentation
Number: 1688
Disease area: Airway diseases
Abstract Rationale: Smoking results in deteriorated clinical and inflammatory outcomes in severe asthma [Thomson et al; JACI 2013]. We aimed to compare clinical, inflammatory and histological characteristics between smoking and non-smoking severe asthma patients.Methods: This was a cross-sectional analysis of the U-BIOPRED adult severe asthma cohort. Clinical, sputum and endobronchial biopsy (immunohistochemistry) data were collected. Group comparisons were undertaken between smokers, ex-smokers and non-smokers and between (ex-)smokers and non-smokers with one-way ANOVA, independent T-test, Mann-Whitney U and Chi-square analyses.Results: Current smokers had significantly lower post-salbutamol FEV₁/FVC %predicted (mean±SD; 75.8±13.2%) than ex-smokers and non-smokers (84.6±15.1 and 84.7±16.2; p=0.014 ). There was a significantly higher number of mast cells within the airway smooth muscle layer in (ex-)smokers compared with non-smokers (median(interquartile range); 18.4(9.6-35.8)cells/mm2 versus 10.3(3.0-14.2); p=0.044 ), in contrast to the mast cells in the epithelium and submucosa (p=0.113 and p=0.787 ). The lamina reticularis was thicker in (ex-)smokers compared with non-smokers (9.7±2.0µm versus 8.5±1.4; p=0.006) and thicker in current smokers compared with ex-smokers and non-smokers (10.4±2.8µm versus 9.4±1.5 versus 8.6±1.4; p=0.010 ).Conclusion: Severe asthma patients who smoke have lower post-bronchodilator lung function than ex-smokers and non-smokers. Notably, smokers and ex-smokers also exhibit a greater number of mast cells within the airway smooth muscle layer and a thicker lamina reticularis suggesting more prominent airway remodeling by smoking in severe asthma.
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P. P. W. Hekking, S. J. Wilson, A. H. Wagener, A. R. Sousa, J. Corfield, D. E. Shaw, S. J. Fowler, L. J. Fleming, J. H. Riley, E. Jeyasingham, A. Rowe, W. Seibold, G. Roberts, P. Bakke, F. Singer, T. Geiser, U. Frey, I. Horvath, R. Polosa, N. Krug, J. Musial, L. Pahus, D. Myles, C. Compton, T. W. Higenbottam, P. Montuschi, U. Nihlén, T. Sandstrom, S. S. Wagers, P. H. Howarth, R. Djukanovic, K. F. Chung, I. Pandis, Y. Guo, A. T. Bansal, E. H. Bel, P. J. Sterk (Amsterdam, Netherlands; Southampton, London, Nottingham, Manchester, Horsham, Cambridge, United Kingdom; Biberach an der Riss, Hannover, Germany; Bergen, Norway; Bern, Switzerland; Budapest, Hungary; Catania, Rome, Italy; Stockholm, Umea, Sweden; Marseille, France; Maasmechelen, Belgium; Krakow, Poland). Clinical and histological comparison of smoking and non-smoking patients with severe asthma in the U-BIOPRED cohort. Eur Respir J 2014; 44: Suppl. 58, 1688
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