Type 2-High Severe Asthma with and without Bronchiectasis: A Prospective Observational Multicentre Study

Claudia Crimi,1 Raffaele Campisi,1 Santi Nolasco,2 Sebastian Ferri,3,4 Giulia Cacopardo,5 Pietro Impellizzeri,2 Maria Provvidenza Pistorio,2 Evelina Fagone,2 Corrado Pelaia,6 Enrico Heffler,3,4 Nunzio Crimi1,2 1Respiratory Medicine Unit, A.O.U. Policlinico “G. Rodolico - San Marco”, Catania, Italy;...

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Autores principales:	Crimi C, Campisi R, Nolasco S, Ferri S, Cacopardo G, Impellizzeri P, Pistorio MP, Fagone E, Pelaia C, Heffler E, Crimi N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	type 2 inflammation severe asthma bronchiectasis chest-ct scan phenotype Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/8ab02688f16640539288bbec43fe5559
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spelling	oai:doaj.org-article:8ab02688f16640539288bbec43fe55592021-11-30T18:50:37ZType 2-High Severe Asthma with and without Bronchiectasis: A Prospective Observational Multicentre Study1178-6965https://doaj.org/article/8ab02688f16640539288bbec43fe55592021-11-01T00:00:00Zhttps://www.dovepress.com/type-2-high-severe-asthma-with-and-without-bronchiectasis-a-prospectiv-peer-reviewed-fulltext-article-JAAhttps://doaj.org/toc/1178-6965Claudia Crimi,1 Raffaele Campisi,1 Santi Nolasco,2 Sebastian Ferri,3,4 Giulia Cacopardo,5 Pietro Impellizzeri,2 Maria Provvidenza Pistorio,2 Evelina Fagone,2 Corrado Pelaia,6 Enrico Heffler,3,4 Nunzio Crimi1,2 1Respiratory Medicine Unit, A.O.U. Policlinico “G. Rodolico - San Marco”, Catania, Italy; 2Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; 3Personalized Medicine, Asthma and Allergy - IRCCS Humanitas Research Hospital, Rozzano, Italy; 4Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy; 5Respiratory Intensive Care Unit, ARNAS Civico General Hospital, Palermo, Italy; 6Department of Medical and Surgical Sciences, University “Magna Graecia”, Catanzaro, ItalyCorrespondence: Claudia CrimiRespiratory Medicine Unit, A.O.U. Policlinico “G. Rodolico - San Marco”, Catania, ItalyEmail dott.claudiacrimi@gmail.comIntroduction: Type 2-high severe asthma (T2-SA) is often associated with several comorbidities. To this extent, the coexistence of T2-SA and bronchiectasis (BE) is considered an emerging phenotype.Methods: We performed a prospective observational multicentre study, including T2-SA patients. Chest HRCT confirmed the presence of BE. Data on exacerbations, pulmonary function, Asthma Control Test (ACT), chronic mucus hypersecretion (CMH), chronic rhinosinusitis (CRS), oral corticosteroid (OCS) dosage, eosinophils in peripheral blood and FeNO were recorded. The Bhalla score was used for radiological assessment of T2-SA+BE patients and the Bronchiectasis Severity Index (BSI) was calculated.Results: A total of 113 patients (mean age 55 ± 11 years, 59.3% female) were enrolled. Co-presence of BE was confirmed in 50/113 (44.2%) patients who identified the T2-SA+BE group. CRS and CRSwNP were more prevalent in T2-SA+BE vs T2-SA [respectively, 42/50 (84%) vs 37/63 (58.7%), p = 0.004 and 27/50 (54%) vs 27/63 (42.9%), p = 0.0165]. Furthermore, T2-SA+BE patients reported more CMH compared to T2-SA [29/50 (58%) vs 15/63 (23.8%), p = 0.0004], were more frequently on chronic OCSs intake [28/50 (56%) vs 22/63 (34.9%), p = 0.0357] and experienced more exacerbations/year [10 (4– 12) vs 6 (4– 12), p = 0.0487]. In a multivariate logistic regression model, the presence of CRS, CMH and daily OCS intake were associated with BE presence with a 78% (95% CI: 69– 88) accuracy. Median Bhalla score was 18.3 (16– 20) (Mild radiological severity). Median BSI was 6 (4– 8) and only 6/50 (12%) had a BSI score ≥ 9. Significant inverse linear relationship between BSI and ACT (r = − 0.6095, p < 0.0001), FEV1% (r = − 0.3297, p = 0.0353) and FEV1 mL (r = − 0.4339, p = 0.0046) were found.Conclusion: Type 2 inflammation could have a causative role in BE development. Chest HRCT is mandatory when a diagnosis of T2-SA is made, especially in presence of CRS, CMH and chronic OCS intake. Early BE detection may be crucial to improve T2-SA patients’ outcomes.Keywords: type 2 inflammation, severe asthma, bronchiectasis, chest-CT scan, phenotypeCrimi CCampisi RNolasco SFerri SCacopardo GImpellizzeri PPistorio MPFagone EPelaia CHeffler ECrimi NDove Medical Pressarticletype 2 inflammationsevere asthmabronchiectasischest-ct scanphenotypeImmunologic diseases. AllergyRC581-607ENJournal of Asthma and Allergy, Vol Volume 14, Pp 1441-1452 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	type 2 inflammation severe asthma bronchiectasis chest-ct scan phenotype Immunologic diseases. Allergy RC581-607
spellingShingle	type 2 inflammation severe asthma bronchiectasis chest-ct scan phenotype Immunologic diseases. Allergy RC581-607 Crimi C Campisi R Nolasco S Ferri S Cacopardo G Impellizzeri P Pistorio MP Fagone E Pelaia C Heffler E Crimi N Type 2-High Severe Asthma with and without Bronchiectasis: A Prospective Observational Multicentre Study
description	Claudia Crimi,1 Raffaele Campisi,1 Santi Nolasco,2 Sebastian Ferri,3,4 Giulia Cacopardo,5 Pietro Impellizzeri,2 Maria Provvidenza Pistorio,2 Evelina Fagone,2 Corrado Pelaia,6 Enrico Heffler,3,4 Nunzio Crimi1,2 1Respiratory Medicine Unit, A.O.U. Policlinico “G. Rodolico - San Marco”, Catania, Italy; 2Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; 3Personalized Medicine, Asthma and Allergy - IRCCS Humanitas Research Hospital, Rozzano, Italy; 4Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy; 5Respiratory Intensive Care Unit, ARNAS Civico General Hospital, Palermo, Italy; 6Department of Medical and Surgical Sciences, University “Magna Graecia”, Catanzaro, ItalyCorrespondence: Claudia CrimiRespiratory Medicine Unit, A.O.U. Policlinico “G. Rodolico - San Marco”, Catania, ItalyEmail dott.claudiacrimi@gmail.comIntroduction: Type 2-high severe asthma (T2-SA) is often associated with several comorbidities. To this extent, the coexistence of T2-SA and bronchiectasis (BE) is considered an emerging phenotype.Methods: We performed a prospective observational multicentre study, including T2-SA patients. Chest HRCT confirmed the presence of BE. Data on exacerbations, pulmonary function, Asthma Control Test (ACT), chronic mucus hypersecretion (CMH), chronic rhinosinusitis (CRS), oral corticosteroid (OCS) dosage, eosinophils in peripheral blood and FeNO were recorded. The Bhalla score was used for radiological assessment of T2-SA+BE patients and the Bronchiectasis Severity Index (BSI) was calculated.Results: A total of 113 patients (mean age 55 ± 11 years, 59.3% female) were enrolled. Co-presence of BE was confirmed in 50/113 (44.2%) patients who identified the T2-SA+BE group. CRS and CRSwNP were more prevalent in T2-SA+BE vs T2-SA [respectively, 42/50 (84%) vs 37/63 (58.7%), p = 0.004 and 27/50 (54%) vs 27/63 (42.9%), p = 0.0165]. Furthermore, T2-SA+BE patients reported more CMH compared to T2-SA [29/50 (58%) vs 15/63 (23.8%), p = 0.0004], were more frequently on chronic OCSs intake [28/50 (56%) vs 22/63 (34.9%), p = 0.0357] and experienced more exacerbations/year [10 (4– 12) vs 6 (4– 12), p = 0.0487]. In a multivariate logistic regression model, the presence of CRS, CMH and daily OCS intake were associated with BE presence with a 78% (95% CI: 69– 88) accuracy. Median Bhalla score was 18.3 (16– 20) (Mild radiological severity). Median BSI was 6 (4– 8) and only 6/50 (12%) had a BSI score ≥ 9. Significant inverse linear relationship between BSI and ACT (r = − 0.6095, p < 0.0001), FEV1% (r = − 0.3297, p = 0.0353) and FEV1 mL (r = − 0.4339, p = 0.0046) were found.Conclusion: Type 2 inflammation could have a causative role in BE development. Chest HRCT is mandatory when a diagnosis of T2-SA is made, especially in presence of CRS, CMH and chronic OCS intake. Early BE detection may be crucial to improve T2-SA patients’ outcomes.Keywords: type 2 inflammation, severe asthma, bronchiectasis, chest-CT scan, phenotype
format	article
author	Crimi C Campisi R Nolasco S Ferri S Cacopardo G Impellizzeri P Pistorio MP Fagone E Pelaia C Heffler E Crimi N
author_facet	Crimi C Campisi R Nolasco S Ferri S Cacopardo G Impellizzeri P Pistorio MP Fagone E Pelaia C Heffler E Crimi N
author_sort	Crimi C
title	Type 2-High Severe Asthma with and without Bronchiectasis: A Prospective Observational Multicentre Study
title_short	Type 2-High Severe Asthma with and without Bronchiectasis: A Prospective Observational Multicentre Study
title_full	Type 2-High Severe Asthma with and without Bronchiectasis: A Prospective Observational Multicentre Study
title_fullStr	Type 2-High Severe Asthma with and without Bronchiectasis: A Prospective Observational Multicentre Study
title_full_unstemmed	Type 2-High Severe Asthma with and without Bronchiectasis: A Prospective Observational Multicentre Study
title_sort	type 2-high severe asthma with and without bronchiectasis: a prospective observational multicentre study
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/8ab02688f16640539288bbec43fe5559
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Type 2-High Severe Asthma with and without Bronchiectasis: A Prospective Observational Multicentre Study

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