Atopy in Patients with Bronchiectasis: More than Coincidence

Abstract

Bronchiectasis is common in developing countries, but its precise underlying mechanism can be detected in only about 40% of the cases. The studies reporting the frequency of atopy and its relation to radiological findings and lung function in bronchiectasis are limited in number, and the results are controversial. The present study was designed to investigate the relationship between atopy and bronchiectasis by means of high resolution computed tomography (HRCT) and pulmonary function tests. Skin prick test, HRCT and pulmonary function tests, including spirometric values of forced expiratory volume in one second (FEV1), FEV1/FVC (forced vital capacity) ratio were performed in 121 bronchiectatic patients of unknown etiology and in 68 healthy controls. Atopy and HRCT scores for the severity of atopy and extent of bronchiectasis respectively were determined for each patient. The rate of atopy (48.8% vs 11.8%) and mean atopy score (14.3 ± 10.1 mm vs 5.5 ± 2.1 mm) were significantly higher in patients with bronchiectasis than those in controls. Atopic patients had significantly worse spirometric values and more extended bronchiectasis than non-atopics. There is a significant correlation between atopy and HRCT scores (r = 0.54, p < 0.001), indicating that the more severe atopy is the more extended bronchiectasis. In conclusion, we suggest that the rate of atopy is higher in bronchiectatic patients than that in healthy controls. Bronchiectatic patients with atopy have lower spirometric values and higher HRCT scores. Atopy might be considered as a deteriorating and/or a causative or contributing factor for development of bronchiectasis.

Hypersensitivity to aeroallergens in patients with recurrent vulvovaginitis of undetermined etiology

“…Nonspecific vaginal hypersensitivity, which can be triggered by nonallergic factors as in other target organs of the allergy, may be another pathogenetic mechanism of allergic vulvoginitis 1 . Recurrent bacterial, viral and parasitic infections may be likely to induce atopy and hypersensitivity as suggested previously 20 …”

“…1 Recurrent bacterial, viral and parasitic infections may be likely to induce atopy and hypersensitivity as suggested previously. 20 To our knowledge, this study has demonstrated the association of atopy and RVV with undetermined etiology for the first time in the published literature, as patients with recurrent vaginal candidiasis were mostly included in other studies dealing with the issue. [3][4][5][6] Although SPT is a valuable and useful diagnostic tool to document atopy in daily medical practice, we must admit that lack of vaginal provocation test during an asymptomatic period, determination of total and specific IgE levels and eosinophil count in blood and vaginal smears as limitations of our study.…”

An investigation into biomarkers for the diagnosis of ABPA and aspergillus disease in cystic fibrosis

“…Male N (%) 4 (50) 6 (50) 19 (45) F508 homozygous N (%) 3 (37) 6 (50) 24 (57) F508 heterozygous N (%) 4 (50) 5 (41) 11 (26) Other/Other N (%) 1 (12) 1 (8) 7 (16) Atopic a N (%) 6 (75)* 6 (50)* 11 (26) Number of positive skin tests b N ± SD 3.0 ± 1.5 A high rate of atopy of up to 40% has been reported in adults with CF, 23 we found a similar prevalence among our pediatric population at 37%. It is not clear why atopy is more prevalent in CF than the general population, however, as high rates have also been found in non-CF bronchiectasis 24 it is likely related to chronic airway inflammation, increased epithelial permeability and greater access for aeroallergens into the bronchial mucosa. 25 Similar to findings by Nepomuceno et al, 26 we found that ABPA rates were higher amongst atopic than nonatopic patients (26% vs 5.1%), therefore determination of atopic status with closer surveillance for ABPA in this group of patients is warranted in the clinical setting.…”

KİSTİK FİBROZİS DIŞI BRONŞEKTAZİLİ ÇOCUK OLGULARIN DEĞERLENDİRİLMESİ [Evaluation of pediatric patients with non-cystic fibrosis bronchiectasis]

“…Bronşektazili hastalardaki atopi sıklığı %10-54 arasında değişmektedir (20). Çalışmamızda 4 (%11.4) hastada atopi saptandı.…”