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. 2020 Jun;25(6):613-619.
doi: 10.1111/resp.13688. Epub 2019 Sep 3.

Reduced lung elastic recoil and fixed airflow obstruction in asthma

Katrina O Tonga  1   2   3   4   5   6 , David G Chapman  2   7 , Claude S Farah  2   3   4   8 , Brian G Oliver  2   7 , Sabine C Zimmermann  1   2   3   4 , Stephen Milne  1   2   3   4 , Farid Sanai  2   3   7 , Kanika Jetmalani  2 , Norbert Berend  2   3   6   9 , Cindy Thamrin  2   3 , Gregory G King  1   2   3   10
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Reduced lung elastic recoil and fixed airflow obstruction in asthma

Katrina O Tonga et al. Respirology. 2020 Jun.

Abstract

Background and objective: Fixed airflow obstruction (FAO) in asthma occurs despite optimal inhaled treatment and no smoking history, and remains a significant problem, particularly with increasing age and duration of asthma. Increased lung compliance and loss of lung elastic recoil has been observed in older people with asthma, but their link to FAO has not been established. We determined the relationship between abnormal lung elasticity and airflow obstruction in asthma.

Methods: Non-smoking asthmatic subjects aged >40 years, treated with 2 months of high-dose inhaled corticosteroid/long-acting beta-agonist (ICS/LABA), had FAO measured by spirometry, and respiratory system resistance at 5 Hz (Rrs5 ) and respiratory system reactance at 5 Hz (Xrs5 ) measured by forced oscillation technique. Lung compliance (K) and elastic recoil (B/A) were calculated from pressure-volume curves measured by an oesophageal balloon. Linear correlations between K and B/A, and forced expiratory volume in 1 s/forced vital capacity (FEV1 /FVC), Rrs5 and Xrs5 were assessed.

Results: Eighteen subjects (11 males; mean ± SD age: 64 ± 8 years, asthma duration: 39 ± 22 years) had moderate FAO measured by spirometry ((mean ± SD z-score) post-bronchodilator FEV1 : -2.2 ± 0.5, FVC: -0.7 ± 1.0, FEV1 /FVC: -2.6 ± 0.7) and by increased Rrs5 (median (IQR) z-score) 2.7 (1.9 to 3.2) and decreased Xrs5 : -4.1(-2.4 to -7.3). Lung compliance (K) was increased in 9 of 18 subjects and lung elastic recoil (B/A) reduced in 5 of 18 subjects. FEV1 /FVC correlated negatively with K (rs = -0.60, P = 0.008) and Rrs5 correlated negatively with B/A (rs = -0.52, P = 0.026), independent of age. Xrs5 did not correlate with lung elasticity indices.

Conclusion: Increased lung compliance and loss of elastic recoil relate to airflow obstruction in older non-smoking asthmatic subjects, independent of ageing. Thus, structural lung tissue changes may contribute to persistent, steroid-resistant airflow obstruction.

Clinical trial registration: ACTRN126150000985583 at anzctr.org.au (UTN: U1111-1156-2795).

Keywords: asthma; fixed airflow obstruction; forced oscillatory airway resistance; lung compliance; lung elastic recoil.

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Comment in

  • Is asthma only an airways disorder?
    Bossé Y, Boulet LP. Bossé Y, et al. Respirology. 2020 Jun;25(6):568-569. doi: 10.1111/resp.13716. Epub 2019 Oct 16. Respirology. 2020. PMID: 31617261 No abstract available.

References

REFERENCES

    1. Bel EH. Clinical phenotypes of asthma. Curr. Opin. Pulm. Med. 2004; 10: 44-50.
    1. Brown T, Jones T, Gove K, Barber C, Elliott S, Chauhan A, Howarth P. Randomised controlled trials in severe asthma: selection by phenotype or stereotype. Eur. Respir. J. 2018; 52: 1801444.
    1. Contoli M, Baraldo S, Marku B, Casolari P, Marwick JA, Turato G, Romagnoli M, Caramori G, Saetta M, Fabbri LM et al. Fixed airflow obstruction due to asthma or chronic obstructive pulmonary disease: 5-year follow-up. J. Allergy Clin. Immunol. 2010; 125: 830-7.
    1. 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: 744-8.
    1. Woodruff PG, Khashayar R, Lazarus SC, Janson S, Avila P, Boushey HA, Segal M, Fahy JV. Relationship between airway inflammation, hyperresponsiveness, and obstruction in asthma. J. Allergy Clin. Immunol. 2001; 108: 753-8.

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