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Clinical characteristics of children and adolescents with severe therapy-resistant asthma in Brazil

Overview of attention for article published in Jornal Brasileiro de Pneumologia, August 2015
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Title
Clinical characteristics of children and adolescents with severe therapy-resistant asthma in Brazil
Published in
Jornal Brasileiro de Pneumologia, August 2015
DOI 10.1590/s1806-37132015000004462
Pubmed ID
Authors

Rodrigues, Andrea Mendonça, Roncada, Cristian, Santos, Giovana, Heinzmann-Filho, João Paulo, Souza, Rodrigo Godinho de, Vargas, Mauro Henrique Moraes, Pinto, Leonardo Araújo, Jones, Marcus Herbert, Stein, Renato Tetelbom, Pitrez, Paulo Márcio

Abstract

To describe the clinical characteristics, lung function, radiological findings, and the inflammatory cell profile in induced sputum in children and adolescents with severe therapy-resistant asthma (STRA) treated at a referral center in southern Brazil. We retrospectively analyzed children and adolescents (3-18 years of age) with uncontrolled STRA treated with high-dose inhaled corticosteroids and long-acting β2 agonists. We prospectively collected data on disease control, lung function, skin test reactivity to allergens, the inflammatory cell profile in induced sputum, chest CT findings, and esophageal pH monitoring results. We analyzed 21 patients (mean age, 9.2 ± 2.98 years). Of those, 18 (86%) were atopic. Most had uncontrolled asthma and near-normal baseline lung function. In 4 and 7, induced sputum was found to be eosinophilic and neutrophilic, respectively; the inflammatory cell profile in induced sputum having changed in 67% of those in whom induced sputum analysis was repeated. Of the 8 patients receiving treatment with omalizumab (an anti-IgE antibody), 7 (87.5%) showed significant improvement in quality of life, as well as significant reductions in the numbers of exacerbations and hospitalizations. Children with STRA present with near-normal lung function and a variable airway inflammatory pattern during clinical follow-up, showing a significant clinical response to omalizumab. In children, STRA differs from that seen in adults, further studies being required in order to gain a better understanding of the disease mechanisms.

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Geographical breakdown

Country Count As %
Unknown 46 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 8 17%
Student > Bachelor 5 11%
Other 5 11%
Researcher 5 11%
Student > Postgraduate 4 9%
Other 8 17%
Unknown 11 24%
Readers by discipline Count As %
Medicine and Dentistry 18 39%
Immunology and Microbiology 4 9%
Nursing and Health Professions 3 7%
Biochemistry, Genetics and Molecular Biology 3 7%
Pharmacology, Toxicology and Pharmaceutical Science 3 7%
Other 4 9%
Unknown 11 24%