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Inflammatory patterns in fixed airflow obstruction are dependent on the presence of asthma
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.ORCID iD: 0000-0002-0198-2718
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.ORCID iD: 0000-0003-0784-0443
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Abstract [en]

Background: Fixed airflow obstruction (FAO) can complicate asthma. Inflammation is a proposed underlying mechanism. The aim with this cross-sectional study was to evaluate the blood leucocyte pattern and level of exhaled nitric oxide in asthmatics and non-asthmatics with or without FAO.

Methods: A total of 11,579 individuals aged ≥20 years from the US National Health and Nutrition Examination Survey were included. They were grouped as: controls without asthma and FAO (n=9,935), asthmatics without FAO (n=674), asthmatics with FAO (n=180) and non-asthmatics with FAO (n=790). FAO was defined as post-bronchodilator FEV1/FVC < lower limit of normal. Exhaled nitric oxide ≥ 25ppb, blood eosinophil levels ≥300 cells/μL, and blood neutrophil levels ≥5100 cells/μL were defined as elevated.

Results: Elevated blood eosinophil levels were more common in all groups compared to the controls, and the group with asthma and fixed airflow obstruction had the highest prevalence of all groups (p<0.01). In a multiple logistic regression model adjusted for potential confounders including smoking, the asthma groups had significantly higher odds ratios for elevated B-Eos levels compared to the control group (odds ratio 1.4, (confidence interval: 1.1-1.7) for the asthma group without fixed airflow obstruction and 2.5 (1.4-4.2) for the asthma group with fixed airflow obstruction). The group with fixed airflow obstruction without asthma had higher odds ratio for elevated blood neutrophil levels compared to the controls: 1.4 (1.1-1.8).

Conclusion: Fixed airflow obstruction in asthma was associated with elevated blood eosinophil levels, whereas fixed airflow obstruction without asthma was associated with elevated blood neutrophil levels.

Keywords [en]
Eosinophil, FeNO, neutrophil, asthma, fixed airflow obstruction
National Category
Respiratory Medicine and Allergy
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URN: urn:nbn:se:uu:diva-406038OAI: oai:DiVA.org:uu-406038DiVA, id: diva2:1411560
Available from: 2020-03-03 Created: 2020-03-03 Last updated: 2020-03-04
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Mogensen, IdaAlving, KjellJansson, ChristerMalinovschi, Andrei

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Lung- allergy- and sleep researchClinical PhysiologyPaediatric Inflammation, Metabolism and Child Health ResearchOccupational and Environmental MedicineIntegrative Physiology
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