Prospective predictors of exacerbation status in severe asthma over a 3-year follow-up
Prospective predictors of exacerbation status in severe asthma over a 3-year follow-up
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DOI：
10.1111/cea.13170
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发表时间：
2018-09-01
影响因子：
6.1
通讯作者：
Nishimura, M.
中科院分区：
文献类型：
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作者：
Kimura, H.;Konno, S.;Nishimura, M.
背景：病情恶化的易感性被认为是一种独特的表型，先前的病情恶化是与未来病情恶化相关的最强临床因素。因此，为了确定与哮喘加重相关的其他新的生物标志物，过去的加重状态必须作为一个混杂因素包括在内。目的探讨重症哮喘患者哮喘加重的临床和生物标志物特征。方法对105例重症哮喘患者3年的临床参数及病情恶化情况进行评价。我们将受试者分为3组：(i)一致的非加重者（CNE，在3年期间未经历任何加重的受试者）；（ii）持续频繁加重者（CFE，频繁加重的受试者，定义为在3年期间的1年内有2次或2次以上加重者）；（iii）间歇性恶化（IE）。我们对两组间的多因素比较进行了多变量分析，包括几个th2相关的生物标志物，以及过去的恶化状态。结果CNE 39例，CFE 15例，IE 51例。前一年的频繁恶化预示着下一年的恶化(P
BackgroundA predisposition to exacerbations is being recognized as a distinct phenotype with previous exacerbations representing the strongest clinical factor associated with future exacerbation. Thus, to identify additional novel biomarkers associated with asthma exacerbations, past exacerbation status must be included as a confounding factor.ObjectiveThis study aimed to characterize the clinical and biomarker features associated with asthma exacerbations in severe asthma.MethodsWe evaluated clinical parameters from 105 severe asthmatics yearly for 3years, as well as their exacerbation status. We classified the subjects into 3 groups: (i) consistent non-exacerbators (CNE, subjects who did not experience any exacerbation over the 3-year period); (ii) consistent frequent exacerbators (CFE, subjects with frequent exacerbation, defined as those who had 2 or more exacerbations within 1year, throughout the 3-year period); and (iii) intermittent exacerbators (IE). We conducted multivariate analysis for comparisons among the groups for multiple factors, including several Th2-related biomarkers, in addition to the past exacerbation status.ResultsThirty-nine subjects were classified as CNE, 15 as CFE, and 51 as IE. Frequent exacerbations in the previous year predicted exacerbations for the following year (P