The Link between Asthma and Bronchiectasis: State of the Art
The Link between Asthma and Bronchiectasis: State of the Art
复制标题
DOI：
10.1159/000507228
复制
发表时间：
2020-01-01
期刊：
影响因子：
3.7
通讯作者：
Crimi, Nunzio
中科院分区：
文献类型：
--
作者：
Crimi, Claudia;Ferri, Sebastian;Crimi, Nunzio
对哮喘相关合并症的不识别通常是治疗失败和症状恶化的原因，并且与频繁加重、更高的疾病严重程度和增加的医疗费用相关。支气管扩张是最常见的哮喘相关合并症之一，可增加气道炎症和加重率，并导致呼吸功能损害。本文的目的是回顾支气管扩张和哮喘之间的相互作用，以便更好地识别两种疾病之间重叠的患者，并选择“特设”治疗。使用以下检索词在PubMed/MEDLINE上进行文献检索：哮喘中的支气管扩张、哮喘与支气管扩张之间的关系、哮喘合并症和重度哮喘。本文对哮喘和支气管扩张的误诊或低估、支气管扩张在哮喘中的患病率、支气管扩张对哮喘的影响、两种疾病的影像学特征、发病机制和常见病因（如胃食管反流病、免疫缺陷、慢性鼻窦炎和过敏性支气管肺曲霉病、哮喘和支气管扩张的治疗）进行了分析。对于重度哮喘、频繁急性发作和标准治疗无效的患者，应怀疑并研究支气管扩张和哮喘的伴随存在。这种临床表型的特征是疾病更严重、结局更差和功能下降，必须很容易识别，以便选择最合适的治疗方法，能够潜在地改善支气管哮喘的管理，预防急性发作和功能下降，并降低医疗费用。(c)2020年南Karger AG，巴塞尔
The nonrecognition of asthma-associated comorbidities is often responsible for the therapeutic failure and the worsening of symptoms, and it is associated with frequent exacerbations, higher disease severity, and increased health costs. Bronchiectasis, one of the most frequent asthma-associated comorbidities, can increase airways inflammation and exacerbation rates and cause respiratory functional impairment. The aim of this article is to review the interactions between bronchiectasis and asthma, in order to better identify patients in the overlap between the 2 diseases and to select an "ad hoc" therapy. A literature search on PubMed/MEDLINE was performed using the following search terms: bronchiectasis in asthma, the association between asthma and bronchiectasis, comorbidities in asthma, and severe asthma. This review analyzed the following items: incorrect or underestimated diagnosis of asthma and bronchiectasis, prevalence of bronchiectasis in asthma, the impact of bronchiectasis in asthma, radiological imaging features of the 2 diseases, etiopathogenesis, and common causes (such as gastroesophageal reflux disease, immune deficits, chronic rhinosinusitis and allergic bronchopulmonary aspergillosis, and treatment of asthma and bronchiectasis). The concomitant presence of bronchiectasis and asthma should be suspected and investigated in patients with severe asthma, frequent exacerbations, and not responding to standard therapy. This clinical phenotype, characterized by a more severe disease, worse outcomes, and functional decline, must be readily recognized in order to choose the most appropriate therapeutic approach, able to potentially improve the management of bronchial asthma, to prevent the onset of exacerbations as well the functional decline, and to reduce health costs. (c) 2020 S. Karger AG, Basel