Does asthma-bronchiectasis overlap syndrome (ABOS) really exist?

Tiotiu, Angélica; Martínez-García, Miguel-Ángel; Méndez‐Brea, Paula; Roibas-Veiga, Iria; González‐Barcala, Francisco‐Javier

doi:10.1080/02770903.2023.2203743

Cited by 3 publications

(1 citation statement)

References 63 publications

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“…Patients with coexisting bronchiectasis and asthma (asthma-bronchiectasis overlap syndrome [ABOS]) reportedly had a higher exacerbation frequency than those with bronchiectasis alone. 1,4 Despite the high prevalence, little is known regarding the pathophysiology of ABOS. Moreover, there is no study that explores the causal relationship between asthma and bronchiectasis.…”

Section: Introductionmentioning

confidence: 99%

Bacteria and viruses and clinical outcomes of asthma‐bronchiectasis overlap syndrome: A cohort study

Zhang,

He,

Pan

et al. 2024

Clinical & Translational All

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BackgroundDespite the high prevalence of co‐existing bronchiectasis and asthma (asthma‐bronchiectasis overlap syndrome [ABOS]), little is known regarding the dominant pathogens and clinical correlates.ObjectiveTo investigate the bacteria and viruses which differentially dominate in ABOS (including its subtypes) compared with bronchiectasis alone, and determine their relevance with bronchiectasis severity and exacerbations.MethodsThis was a prospective observational cohort study conducted between March 2017 and August 2023. We included 81 patients with ABOS and 107 patients with bronchiectasis alone. At steady‐state baseline, patients underwent comprehensive assessments and sputum collection for bacterial culture and viral detection (quantitative polymerase‐chain‐reaction). Patients were followed‐up to record exacerbation and spirometry.ResultsPatients with ABOS had significantly higher symptom burden and exacerbation frequency than those with bronchiectasis alone. Despite similar pathogen spectrum, the rate of bacteria–virus co‐detection increased less substantially at acute exacerbations (AE) onset than at steady‐state compared with bronchiectasis alone. Pathogenic bacteria (particularly Pseudomonas aeruginosa) were detected fairly common (exceeding 50%) in ABOS and were associated with greater severity of bronchiectasis when stable and conferred greater exacerbation risks at follow‐up. Viral but not bacterial compositions changed substantially at AE onset compared with clinical stability. Higher blood eosinophil count, moderate‐to‐severe bronchiectasis and non‐atopy were associated with higher odds of bacterial, but not viral, detection (all p < 0.05).ConclusionDetection of bacteria or virus is associated with bronchiectasis severity or clinical outcomes in ABOS. This highlights the importance of integrating sputum microbial assessment for ascertaining the dominant pathophysiology (atopy vs. infection) and longitudinal trajectory prediction in ABOS.

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Section: Introductionmentioning

confidence: 99%

Bacteria and viruses and clinical outcomes of asthma‐bronchiectasis overlap syndrome: A cohort study

Zhang,

He,

Pan

et al. 2024

Clinical & Translational All

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Association of asthma and bronchiectasis: Mendelian randomization analyses and observational study

Fan,

Qian,

et al. 2024

Respir Res

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Background Previous studies have demonstrated that asthma is closely associated with bronchiectasis, however, the causal relationship between asthma and bronchiectasis has not been investigated in depth. Therefore, this study aims to explore the causal relationship and to identify potential factors that mediate between these two diseases. Method All the necessary summarized information were obtained from publicly available genome-wide association study (GWAS). Two-sample Mendelian randomization (two-sample MR) was employed to explore the causal relationship between asthma and bronchiectasis, with an additional dataset used for validation. Heterogeneity and pleiotropy analyses were utilized to verify the robustness of the results. Subsequently, mediation MR analyses were performed to identify potential mediating factors. Lastly, a retrospective observational study was conducted to validate the findings. Result Preliminary inverse-variance weighted (IVW) results indicated there was a causal effect of asthma on bronchiectasis (odds ratio [OR] = 1.228, 95% confidence interval [CI]: 1.077–1.400, P = 0.002). Repetition validation yielded a consistent result. Mediation MR analysis demonstrated that the presence of nasal polyps (OR = 1.063, 95% CI: 1.015–1.113, mediation ratio = 30.492%, P = 0.009), acute sinusitis (OR = 1.062, 95% CI: 1.009–1.118, mediation ratio = 30.157%, P = 0.018), chronic sinusitis (OR = 1.085, 95% CI: 1.024–1.150, mediation ratio = 40.677%, P = 0.005), and peripheral eosinophil counts (OR = 1.013, 95% CI: 1.000–1.026, mediation ratio = 6.514%, P = 0.042) served as significant mediators in the occurrence and development of bronchiectasis induced by asthma. Furthermore, a retrospective observational study observed that bronchiectasis patients with asthma had a higher prevalence of sinusitis (5.043% vs 2.971%, P < 0.001), nasal polyps (0.536% vs 0.152%, P < 0.001), and rhinitis (13.197% vs 1.860%, P < 0.001). The ratio (1.950 (0.500, 5.600) vs 1.500 (0.500, 2.600), P = 0.006) and counts (0.125 (0.040, 0.363) vs 0.090 (0.030, 0.160), P < 0.001) of peripheral blood eosinophils were also elevated in bronchiectasis patients with asthma. Conclusion The MR analysis uncovered a notable genetic association between asthma and bronchiectasis, which was partially mediated by sinusitis, nasal polyps, and eosinophils. A subsequent retrospective study provided further evidence by demonstrating that bronchiectasis patients with asthma had a higher prevalence of sinusitis, nasal polyps, an elevated proportion of eosinophils, and higher eosinophil counts. Supplementary Information The online version contains supplementary...

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Challenges in the Management of Long-Therm Corticotherapy Treatment at Smoker Pacient with Severe Asthma

Slabu,

Catrangiu,

Iorga

2023

Internal Medicine

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Asthma is a chronic obstructive disease with high morbidity and mortality despite modern diagnostic and treatment methods. Oral corticosteroid therapy has been the mainstay treatment for severe asthma for almost a century, improving the patient's quality of life by reducing the severity and frequency of asthma attacks. However, long-term systemic corticosteroid administration has disadvantages owing to the increased prevalence of adverse effects. In recent years, the use of targeted biological therapies has increased, prompting us to question the current role of corticosteroid therapy in the management of severe eosinophilic asthma. We present the case of a 49-year-old female patient, who smoked (25 pack-years) and was diagnosed with asthma 20 years ago based on clinical, biological, and spirometric criteria. The patient was treated with prednisone (10 mg/day). This study aimed to demonstrate the potential long-term effects of corticosteroid administration in smokers with severe asthma who had clear criteria for initiating biological therapy.

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Does asthma-bronchiectasis overlap syndrome (ABOS) really exist?

Cited by 3 publications

References 63 publications

Bacteria and viruses and clinical outcomes of asthma‐bronchiectasis overlap syndrome: A cohort study

Bacteria and viruses and clinical outcomes of asthma‐bronchiectasis overlap syndrome: A cohort study

Association of asthma and bronchiectasis: Mendelian randomization analyses and observational study

Challenges in the Management of Long-Therm Corticotherapy Treatment at Smoker Pacient with Severe Asthma

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