Comparative clinical and airway inflammatory features of asthmatics with or without polyps

Rhinology. 2010 Dec;48(4):420-5. doi: 10.4193/Rhino09.095.

Abstract

Background: Nasal polyposis (NP) is associated with a more severe and steroid-resistant asthma.

Objective: To compare clinical and airway inflammatory features of asthmatics with or without NP.

Methods: Two groups of asthmatic patients were studied: group 1; n=39, with NP; group 2; n=40, without NP. Asthma control was assessed according to the Asthma Control Scoring System (ACSS). Expiratory flows, induced sputum, and blood eosinophils were also measured.

Results: ACSS score was lower (poorer control) in group 1 (meanA+-SEM = 73A+-3%) compared with group 2 (82A+-2%, p=0.01). FEV1 (mean of predicted value A+- SEM) was 81A+-3 for group 1 and 96A+-3 for group 2 (p=0.001), and the FEV1/FVC ratio was lower in group 1 (70A+-2%) compared with group 2 (76A+-1%, p=0.01). Blood and induced sputum eosinophils, as well as fibronectin and eosinophil cationic protein levels, were higher in group 1.

Conclusion: Asthmatic subjects with NP have increased airway obstruction, increased inflammatory cells and reduced asthma control compared to those without NP. This may suggest a contribution of nasal polyps to the severity of asthma or a common susceptibility to develop upper and lower airways mucosal inflammation.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Airway Obstruction / drug therapy
  • Airway Obstruction / etiology
  • Airway Obstruction / metabolism
  • Airway Obstruction / pathology
  • Airway Obstruction / physiopathology
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma* / complications
  • Asthma* / diagnosis
  • Asthma* / drug therapy
  • Asthma* / metabolism
  • Asthma* / physiopathology
  • Disease Progression*
  • Drug Resistance*
  • Eosinophil Cationic Protein / metabolism
  • Eosinophils / metabolism
  • Female
  • Fibronectins / metabolism
  • Humans
  • Male
  • Middle Aged
  • Nasal Polyps* / complications
  • Nasal Polyps* / diagnosis
  • Nasal Polyps* / metabolism
  • Nasal Polyps* / physiopathology
  • Respiratory Mucosa / drug effects
  • Respiratory Mucosa / metabolism
  • Respiratory Mucosa / pathology
  • Severity of Illness Index
  • Skin Tests
  • Spirometry
  • Sputum / drug effects
  • Sputum / metabolism

Substances

  • Anti-Asthmatic Agents
  • Fibronectins
  • Eosinophil Cationic Protein