Information de reference pour ce titreAccession Number: | 00000381-200904000-00011.
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Author: | Cottin, V. 1; Khouatra, C. 1; Dubost, R. 1; Glerant, J -C. 2; Cordier, J -F. 1
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Institution: | (1)Hospices civils de Lyon, Hopital Louis Pradel, Service de pneumologie - centre de reference des maladies orphelines pulmonaires, Universite de Lyon, Universite Lyon I, UCBL-INRA-ENVL-EPHE, UMR754, IFR128, Lyon (2)Hospices civils de Lyon, Hopital Louis Pradel, Laboratoire d'exploration fonctionnelle respiratoire, Lyon, France
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Title: | |
Source: | Allergy. 64(4):589-595, April 2009.
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Abstract: | Background: Little is known about the long-term outcome of airflow obstruction in asthma of patients with Churg-Strauss syndrome (CSS).
Methods: We conducted a retrospective study of 24 consecutive patients (aged 41.1 +/- 13.5 years) with CSS in a single center. All had asthma (starting 8.1 +/- 9.5 years prior to the diagnosis of CSS), blood eosinophilia (6.1 +/- 4.4 x 109/l) and systemic manifestations of CSS. Antineutrophil cytoplasmic antibodies were found in 7 of 22 tested patients. Seven patients had smoked (a mean of 10 pack-years). All patients received oral corticosteroids, 11 cyclophosphamide and 23 inhaled corticosteroids.
Results: Airflow obstruction was found in 14 patients (70%) at diagnosis, and in 11 of 22 patients (50%) at the time of the clinical remission of CSS. The mean postbronchodilator FEV1/FVC and FEV1 were 69 +/- 12% and 74 +/- 21% of predicted at diagnosis (n = 20); 71 +/- 10% and 92 +/- 19% of predicted at the clinical remission (n = 22); and 64 +/- 13% and 80 +/- 21% at last visit (n = 13), respectively. During follow-up, postbronchodilator FEV1 increased by 30 +/- 28% in six patients with FEV1/FVC < 70% despite inhaled therapy who received higher dose of oral corticosteroids. At last visit, 5 of 13 patients (38%) with more than 3 years of follow-up had persistent airflow obstruction as defined by postbronchodilator FEV1/FVC < 70% and FEV1 < 80% of predicted.
Conclusion: Airflow obstruction due to uncontrolled asthma is present despite corticosteroids in many patients at diagnosis and at clinical remission of CSS, and during follow-up. It may be still partly reversible with increased oral corticosteroid treatment.
Copyright (C) 2009 Blackwell Publishing Ltd.
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Author Keywords: | airflow obstruction; asthma; Churg-Strauss syndrome; eosinophil; vasculitis; ventilatory defect.
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References: | 1. Pagnoux C, Guilpain P, Guillevin L. Churg-Strauss syndrome. Curr Opin Rheumatol 2007;19:25-32.
2. Sable-Fourtassou R, Cohen P, Mahr A, Pagnoux C, Mouthon L, Jayne D et al. Antineutrophil cytoplasmic antibodies and the Churg-Strauss syndrome. Ann Intern Med 2005;143:632-638.
3. Sinico RA, Di Toma L, Maggiore U, Bottero P, Radice A, Tosoni C et al. Prevalence and clinical significance of antineutrophil cytoplasmic antibodies in Churg-Strauss syndrome. Arthritis Rheum 2005;52:2926-2935.
4. Jennette JC, Falk RJ, Andrassy K, Bacon PA, Churg J, Gross WL et al. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum 1994; 37:187-192.
5. Tsurikisawa N, Tsuburai T, Saito H, Morita S, Horiguchi Y, Mitomi H et al. A retrospective study of bronchial hyperresponsiveness in patients with asthma before the onset of Churg-Strauss syndrome. Allergy Asthma Proc 2007;28:336-343.
6. Lanham JG, Elkon KB, Pusey CD, Hughes GR. Systemic vasculitis with asthma and eosinophilia: a clinical approach to the Churg-Strauss syndrome. Medicine (Baltimore) 1984; 63:65-81.
7. Guillevin L, Cohen P, Gayraud M, Lhote F, Jarrousse B, Casassus P. Churg-Strauss syndrome. Clinical study and long-term follow-up of 96 patients. Medicine (Baltimore) 1999;78:26-37.
8. Masi AT, Hunder GG, Lie JT, Michel BA, Bloch DA, Arend WP et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum 1990;33:1094-1100.
9. Guillevin L, Lhote F, Gayraud M, Cohen P, Jarrousse B, Lortholary O et al. Prognostic factors in polyarteritis nodosa and Churg-Strauss syndrome. A prospective study in 342 patients. Medicine (Baltimore) 1996;75:17-28.
10. Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2007;176:532-555.
11. Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl 1993;16:5-40.
12. Chumbley LC, Harrison EG Jr, DeRemee RA. Allergic granulomatosis and angiitis (Churg-Strauss syndrome). Report and analysis of 30 cases. Mayo Clin Proc 1977;52:477-484.
13. Keogh KA, Specks U. Churg-Strauss syndrome: clinical presentation, antineutrophil cytoplasmic antibodies, and leukotriene receptor antagonists. Am J Med 2003;115:284-290.
14. Ten Brinke A. Risk factors associated with irreversible airflow limitation in asthma. Curr Opin Allergy Clin Immunol 2008;8:63-69.
15. Ten Brinke A, Zwinderman AH, Sterk PJ, Rabe KF, Bel EH. Factors associated with persistent airflow limitation in severe asthma. Am J Respir Crit Care Med 2001;164:744-748.
16. Ulrik CS, Backer V. Nonreversible airflow obstruction in life-long nonsmokers with moderate to severe asthma. Eur Respir J 1999;14:892-896.
17. Vonk JM, Jongepier H, Panhuysen CI, Schouten JP, Bleecker ER, Postma DS. Risk factors associated with the presence of irreversible airflow limitation and reduced transfer coefficient in patients with asthma after 26 years of follow up. Thorax 2003;58:322-327.
18. Hudon C, Turcotte H, Laviolette M, Carrier G, Boulet LP. Characteristics of bronchial asthma with incomplete reversibility of airflow obstruction. Ann Allergy Asthma Immunol 1997;78:195-202.
19. Jang AS, Lee JH, Park SW, Park JS, Kim DJ, Park CS. Risk factors related to fixed airway obstruction in patients with asthma after antiasthma treatment. Ann Allergy Asthma Immunol 2007; 99:408-412.
20. Lee JH, Haselkorn T, Borish L, Rasouliyan L, Chipps BE, Wenzel SE Risk factors associated with persistent airflow limitation in severe or difficult-to-treat asthma: insights from the TENOR study. Chest 2007;132:1882-1889.
21. Lange P, Parner J, Vestbo J, Schnohr P, Jensen G. A 15-year follow-up study of ventilatory function in adults with asthma. N Engl J Med 1998;339:1194-1200.
22. Bumbacea D, Campbell D, Nguyen L, Carr D, Barnes PJ, Robinson D et al. Parameters associated with persistent airflow obstruction in chronic severe asthma. Eur Respir J 2004;24:122-128.
23. James AL, Palmer LJ, Kicic E, Maxwell PS, Lagan SE, Ryan GF et al. Decline in lung function in the Busselton Health Study: the effects of asthma and cigarette smoking. Am J Respir Crit Care Med 2005;171:109-114.
24. Bai TR, Vonk JM, Postma DS, Boezen HM. Severe exacerbations predict excess lung function decline in asthma. Eur Respir J 2007;30:452-456.
25. Jongepier H, Boezen HM, Dijkstra A, Howard TD, Vonk JM, Koppelman GH et al. Polymorphisms of the ADAM33 gene are associated with accelerated lung function decline in asthma. Clin Exp Allergy 2004;34:757-760.
26. Foley SC, Prefontaine D, Hamid Q. Images in allergy and immunology: role of eosinophils in airway remodeling. J Allergy Clin Immunol 2007;119:1563-1566.
27. Shen ZJ, Esnault S, Rosenthal LA, Szakaly RJ, Sorkness RL, Westmark PR et al. Pin1 regulates TGF-beta1 production by activated human and murine eosinophils and contributes to allergic lung fibrosis. J Clin Invest 2008; 118:479-490.
28. Humbles AA, Lloyd CM, McMillan SJ, Friend DS, Xanthou G, McKenna EE et al. A critical role for eosinophils in allergic airways remodeling. Science 2004;305:1776-1779.
29. Bottero P, Bonini M, Vecchio F, Grittini A, Patruno GM, Colombo B et al. The common allergens in the Churg-Strauss syndrome. Allergy 2007;62:1288-1294.
30. Vaglio A, Martorana D, Maggiore U, Grasselli C, Zanetti A, Pesci A et al. HLA-DRB4 as a genetic risk factor for Churg-Strauss syndrome. Arthritis Rheum 2007;56:3159-3166.
31. Philit F, Etienne-Mastroianni B, Parrot A, Guerin C, Robert D, Cordier JF. Idiopathic acute eosinophilic pneumonia: a study of 22 patients. The Groupe d'Etudes et de Recherche sur les Maladies 'Orphelines' Pulmonaires (GERM'O'P). Am J Respir Crit Care Med 2002;166:1235-1239.
32. Marchand E, Etienne-Mastroianni B, Chanez P, Lauque D, Leclerq P, Cordier JF. Idiopathic chronic eosinophilic pneumonia and asthma: how do they influence each other? The Groupe d'Etudes et de Recherche sur les Maladies 'Orphelines' Pulmonaires (GERM'O'P). Eur Respir J 2003;22:8-13.
33. Snoeck-Stroband JB, Lapperre TS, Gosman MM, Boezen HM, Timens W, ten Hacken NH et al. Chronic bronchitis sub-phenotype within COPD: inflammation in sputum and biopsies. Eur Respir J 2008;31:70-77.
34. Brightling CE, Woltmann G, Wardlaw AJ, Pavord ID. Development of irreversible airflow obstruction in a patient with eosinophilic bronchitis without asthma. Eur Respir J 1999;14:1228-1230.
35. Liard R, Leynaert B, Zureik M, Beguin FX, Neukirch F. Using global initiative for asthma guidelines to assess asthma severity in populations. Eur Respir J 2000;16:615-620.
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Language: | English.
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Document Type: | Original articles.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0105-4538
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NLM Journal Code: | 39c, 7804028
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DOI Number: | https://dx.doi.org/10.1111/j.139...- ouverture dans une nouvelle fenêtre
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