Evaluation of atopy in patients with COPD

• Main Authors: Margarida Celia Lima Costa Neves, Yuri Costa Sarno Neves, Carlos Mauricio Cardeal Mendes, Monalisa Nobre Bastos, Aquiles Assuncao Camelier, Cleriston Farias Queiroz, Bernardo Fonseca Mendoza, Antonio Carlos Moreira Lemos, Argemiro D'Oliveira Junior
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Pneumologia e Tisiologia 2013-06-01
• Series: Jornal Brasileiro de Pneumologia
• Subjects: Doenca pulmonar obstrutiva cronica; Alergia e imunologia; Liquido da lavagem nasal; Asma; Rinite alergica perene
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132013000300296&lng=en&tlng=en

OBJECTIVE: To determine the prevalence of atopy and to evaluate clinical, laboratory, and radiological profiles in patients with COPD. METHODS: This was a cross-sectional study involving outpatients with stable COPD (defined by the clinical history and a post-bronchodilator FEV1/FVC < 70% of the predicted value). The patients completed a questionnaire regarding clinical characteristics and atopy, after which they underwent nasal lavage cytology, skin prick testing, chest X-rays, arterial blood gas analyses, and determination of total serum IgE. RESULTS: Of the 149 subjects studied, 53 (35.6%), 49 (32.8%), and 88 (59.1%) presented with nasal eosinophilia, a positive skin prick test result, and symptoms of allergic rhinitis, respectively. Correspondence analysis confirmed these findings, showing two distinct patterns of disease expression: atopy in patients with COPD that was less severe; and no evidence of atopy in those with COPD that was more severe (reduced FEV1 and hyperinflation). There was a statistically significant association between nasal eosinophilia and a positive bronchodilator response. CONCLUSIONS: Using simple and reproducible methods, we were able to show that there is a high frequency of atopy in patients with COPD. Monitoring inflammation in the upper airways can be a useful tool for evaluating respiratory diseases in the elderly and in those with concomitant asthma and COPD, a clinical entity not yet fully understood.