Abstract
There is limited evidence linking airway inflammation and lung function impairment in older non-smoking asthmatics with fixed airflow obstruction (FAO), which can develop despite treatment with inhaled corticosteroids (ICS). We assessed lung function (spirometry, forced oscillation technique (FOT)), lung elastic recoil and airway inflammation using bronchoalveolar lavage (BAL) in non-smoking adult asthmatics with FAO, following 2 months treatment with high-dose ICS/long-acting beta-agonist. Subjects demonstrated moderate FAO, abnormal FOT indices and loss of lung elastic recoil. This cross-sectional study showed a lack of a relationship between BAL neutrophils, eosinophils, inflammatory cytokines and lung function impairment. Other inflammatory pathways or the effect of inflammation on lung function over time may explain FAO development.
Highlights
There is limited evidence linking airway inflammation and lung function impairment in older non-smoking asthmatics with fixed airflow obstruction (FAO), which can develop despite treatment with inhaled corticosteroids (ICS)
Asthma severity [1, 5] and FAO development may be attributed to corticosteroid resistance or insensitivity resulting in persistent airway inflammation [6] and structural airway changes
Both eosinophilic and neutrophilic inflammation may be associated with lung function impairment and FAO in asthma, evidence is limited and contradictory [4, 7]
Summary
There is limited evidence linking airway inflammation and lung function impairment in older non-smoking asthmatics with fixed airflow obstruction (FAO), which can develop despite treatment with inhaled corticosteroids (ICS). Both eosinophilic and neutrophilic inflammation may be associated with lung function impairment and FAO in asthma, evidence is limited and contradictory [4, 7]. We investigated whether lung function impairment in older non-smokers with long-standing asthma and FAO is associated with the
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