Hagit Levine1, Malena Cohen-Cymberknoh2, Nitai Klein3, Moshe Hoshen4, Huda Mussaffi1, Patrick Stafler1, Oded Breuer2, Eitan Kerem2, Hannah Blau5. 1. Pulmonary Institute and Graub Cystic Fibrosis Center, Schneider Children's Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel. 2. CF Center, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Hebrew University Hadassah Medical School, Jerusalem, Israel. 3. Hebrew University Hadassah Medical School, Jerusalem, Israel. 4. Clalit research institute, Clalit health services, Tel-Aviv, Israel. 5. Pulmonary Institute and Graub Cystic Fibrosis Center, Schneider Children's Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel. Electronic address: hblau@post.tau.ac.il.
Abstract
BACKGROUND: As asthma-like symptoms are common in CF, we evaluated reversible airway obstruction and associated characteristics. METHODS: Retrospective analysis of charts including spirometry and bronchodilator response. RESULTS: Of 190 CF patients (103 at Schneider's, 87 at Hadassah), aged 14.4 (4-76) years, median (range), 39% had reversible obstruction (ΔFEV1% predicted ≥12%), associated with younger age (p=0.01) and severe genotype (p=0.02). There was no association with family history of asthma, serum IgE, blood eosinophils, pancreatic status, FEV1<40% predicted, Aspergillus or pseudomonas infection. Of patients with reversible obstruction, 74% were on bronchodilator and 68% on inhaled corticosteroid therapy but 54% and 57% respectively receiving these therapies did not have reversible obstruction. CONCLUSIONS: Reversible airway obstruction is common in CF, more frequent in younger patients and with severe genotype, with no correlation to markers of atopy or CF clinical severity. Bronchodilator and inhaled corticosteroid therapies are commonly prescribed even without reversible obstruction.
BACKGROUND: As asthma-like symptoms are common in CF, we evaluated reversible airway obstruction and associated characteristics. METHODS: Retrospective analysis of charts including spirometry and bronchodilator response. RESULTS: Of 190 CFpatients (103 at Schneider's, 87 at Hadassah), aged 14.4 (4-76) years, median (range), 39% had reversible obstruction (ΔFEV1% predicted ≥12%), associated with younger age (p=0.01) and severe genotype (p=0.02). There was no association with family history of asthma, serum IgE, blood eosinophils, pancreatic status, FEV1<40% predicted, Aspergillus or pseudomonas infection. Of patients with reversible obstruction, 74% were on bronchodilator and 68% on inhaled corticosteroid therapy but 54% and 57% respectively receiving these therapies did not have reversible obstruction. CONCLUSIONS: Reversible airway obstruction is common in CF, more frequent in younger patients and with severe genotype, with no correlation to markers of atopy or CF clinical severity. Bronchodilator and inhaled corticosteroid therapies are commonly prescribed even without reversible obstruction.
Authors: Vincent D Giacalone; Brian S Dobosh; Amit Gaggar; Rabindra Tirouvanziam; Camilla Margaroli Journal: Int J Mol Sci Date: 2020-05-08 Impact factor: 5.923