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SELECTED ARTICLES FROM THE RECENT LITERATURE 2008
3/24/08
United Airways Concept Applies Not Only to Allergic Asthmatics, but also to Nonallergic Asthmatics and Subjects with COPD
Summary
The authors of this study sought to determine whether or not patients with COPD and intrinsic asthma had more upper airway pathology than normal controls. They stated that this had already been demonstrated for allergic asthmatics. In order to do that, they studied 90 patients with "stable bronchial disease." Thirty-five of these were subjects with allergic asthma, 24 with nonallergic asthma, and 31 had COPD. They were matched against 61 control subjects. The following were assessed:
- Sino-nasal symptoms using a visual analogue scale
- Rhinosinusitis-related impairment of quality of life
- Nasal mucosal abnormalities on exam (nasal endoscopy)
- Nasal secretions assay for eotaxin, interferon gamma, G-CSF, MCP-1, and IP-10
Allergic asthmatics, nonallergic asthmatics, and COPD patients all reported more nasal symptoms than controls. They all had impaired quality of life and demonstrated more mucosal abnormalities on examination. Nasal secretions of allergic and nonallergic asthmatics had higher levels of eotaxin, G-CSF, interferon gamma, and MCP-1. COPD patients had higher levels of eotaxin, G-CSF, and interferon gamma than controls. Also, allergic asthmatics alone showed higher levels of IP-10.
The authors concluded that the "united airways" concept applies not only to allergic asthma, but also to nonallergic asthma and COPD as well.
Reference
Hens G, et al. Sino-nasal pathology in nonallergic asthma and COPD: 'united airway disease' beyond the scope of allergy. In: Allergy 2008; 63(3):261-267.
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