Bronchiectasis in severe asthma and asthmatic components in bronchiectasis |
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| Affiliation: | 1. Department of Respiratory Medicine, Iizuka Hospital, Iizuka, Japan;2. Department of Respiratory Medicine, Juntendo University, School of Medicine, Tokyo, Japan;1. Department of Medical Oncology, Izumi City General Hospital, 4-5-1 Wake, Izumi, Osaka, 594-0073, Japan;2. Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2, Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan;3. Department of Hematology, Izumi City General Hospital, 4-5-1, Wake, Izumi, Osaka, 594-0073, Japan;4. Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5 Yamadaoka, Suita, Osaka, 565- 0871, Japan;5. Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan;6. Department of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo, 193-0998, Japan;7. Department of Pathology, Keiyu Hospital, 3-7-3 Minatomirai Nishi-ku, Yokohama-shi, Kanagawa, 220-8521, Japan;8. Department of Pathology, School of Medicine, International University of Health and Welfare, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan;1. Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan;2. Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan;3. Department of Nursing Science, Faculty of Health Care, Tenri Health Care University, Tenri, Japan;4. Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan;5. Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan;6. Department of Gastroenterology and Hepatology, Itami City Hospital, Itami, Japan;7. Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan;8. Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Kyoto, Japan;9. Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan;10. Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan;11. Department of Respiratory Medicine, Osaka Habikino Medical Center, Habikino, Japan;1. Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan;2. Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, 204-8522, Japan;3. Respiratory Diseases Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, 204-8522, Japan;4. Department of Basic Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan;5. Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, 204-8522, Japan |
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| Abstract: | ![]()
Asthma and bronchiectasis are different diseases; however, differentiating them can be difficult because they share several symptomatic and physiological similarities. Approximately 20% of patients with bronchiectasis have eosinophilic inflammation, 34% show wheezing, and 7–46% have comorbid asthma, although comorbidity with severe asthma may be limited as shown in 3.3% of cases of bronchiectasis. Meanwhile, 25–68% of patients with severe asthma have comorbid bronchiectasis, and at least two phenotypes are present in the accompanying bronchiectasis: eosinophilic bronchiectasis and chronic infectious bronchiolitis/bronchiectasis. Recent studies show that type-2-targeted biologics are effective for eosinophilic bronchiectasis and theoretically effective for some of the remaining cases when used before oral corticosteroids. Further studies are needed to identify treatment strategies for severe asthma with comorbid bronchiectasis and vice versa. |
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| Keywords: | Bronchiectasis Chronic infectious bronchiolitis Exhaled nitric oxide Severe asthma |
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