Near Fatal Asthma: Clinical and Airway Biopsy Characteristics

Near Fatal Asthma: Clinical and Airway Biopsy Characteristics

Background. Inflammation and remodeling are integral parts of asthma pathophysiology. We sought to describe the clinical and pathologic features of near fatal asthma exacerbation (NFE). Methods. Bronchial biopsies were collected prospectively from NFE I subjects. Another NFE II group and a moderate...

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Main Authors: Richard G. Barbers, Ilias C. Papanikolaou, Michael N. Koss, Ashish Patel, Elton Katagihara, Maggie Arenas, Khalid Chan, Colleen G. Azen, Om P. Sharma
Format: Article
Language:English
Published: Hindawi Limited 2012-01-01
Series:Pulmonary Medicine
Online Access:http://dx.doi.org/10.1155/2012/829608
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spelling doaj-2276a44dd0154d54bce8bdd39ee753cc2020-11-24T23:17:52ZengHindawi LimitedPulmonary Medicine2090-18362090-18442012-01-01201210.1155/2012/829608829608Near Fatal Asthma: Clinical and Airway Biopsy CharacteristicsRichard G. Barbers0Ilias C. Papanikolaou1Michael N. Koss2Ashish Patel3Elton Katagihara4Maggie Arenas5Khalid Chan6Colleen G. Azen7Om P. Sharma8Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USABackground. Inflammation and remodeling are integral parts of asthma pathophysiology. We sought to describe the clinical and pathologic features of near fatal asthma exacerbation (NFE). Methods. Bronchial biopsies were collected prospectively from NFE I subjects. Another NFE II group and a moderate severity exacerbation control group (ME II) were retrospectively identified—no biopsies obtained. Results. All NFE II (𝑛=9) subjects exhibited remodeling and significant inflammation (eosinophilic, neutrophilic). NFE II group (𝑛=37) had a significant history of prior intubation and inhaled corticosteroids usage compared to ME II group (𝑛=41). They also exhibited leukocytosis, eosinophilia, and longer hospitalization days. Conclusions. Remodeling, eosinophilic, and neutrophilic inflammation were observed in NFE. NFE is associated with prior intubation and inhaled corticosteroids usage.http://dx.doi.org/10.1155/2012/829608
collection DOAJ
language English
format Article
sources DOAJ
author Richard G. Barbers
Ilias C. Papanikolaou
Michael N. Koss
Ashish Patel
Elton Katagihara
Maggie Arenas
Khalid Chan
Colleen G. Azen
Om P. Sharma
spellingShingle Richard G. Barbers
Ilias C. Papanikolaou
Michael N. Koss
Ashish Patel
Elton Katagihara
Maggie Arenas
Khalid Chan
Colleen G. Azen
Om P. Sharma
Near Fatal Asthma: Clinical and Airway Biopsy Characteristics
Pulmonary Medicine
author_facet Richard G. Barbers
Ilias C. Papanikolaou
Michael N. Koss
Ashish Patel
Elton Katagihara
Maggie Arenas
Khalid Chan
Colleen G. Azen
Om P. Sharma
author_sort Richard G. Barbers
title Near Fatal Asthma: Clinical and Airway Biopsy Characteristics
title_short Near Fatal Asthma: Clinical and Airway Biopsy Characteristics
title_full Near Fatal Asthma: Clinical and Airway Biopsy Characteristics
title_fullStr Near Fatal Asthma: Clinical and Airway Biopsy Characteristics
title_full_unstemmed Near Fatal Asthma: Clinical and Airway Biopsy Characteristics
title_sort near fatal asthma: clinical and airway biopsy characteristics
publisher Hindawi Limited
series Pulmonary Medicine
issn 2090-1836
2090-1844
publishDate 2012-01-01
description Background. Inflammation and remodeling are integral parts of asthma pathophysiology. We sought to describe the clinical and pathologic features of near fatal asthma exacerbation (NFE). Methods. Bronchial biopsies were collected prospectively from NFE I subjects. Another NFE II group and a moderate severity exacerbation control group (ME II) were retrospectively identified—no biopsies obtained. Results. All NFE II (𝑛=9) subjects exhibited remodeling and significant inflammation (eosinophilic, neutrophilic). NFE II group (𝑛=37) had a significant history of prior intubation and inhaled corticosteroids usage compared to ME II group (𝑛=41). They also exhibited leukocytosis, eosinophilia, and longer hospitalization days. Conclusions. Remodeling, eosinophilic, and neutrophilic inflammation were observed in NFE. NFE is associated with prior intubation and inhaled corticosteroids usage.
url http://dx.doi.org/10.1155/2012/829608
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