Relationship between bronchiectasis with wheeze and asthma

Lee, Junehyuk; Hong, Ki Young; Joo, Jae Hak; Kim, Do Jin; Uh, Soo Taek; Kim, Young Hoon; Park, Choon Sik

Abstract

BACKGROUND: Wheezes are the oscillation of airway walls that occures when there is airflow limitation, as may be produced by bronchospasm, airway edema or collapse or intraluminal obstruction by neplasm or secretions. Wheezes can be observed in about 34% of bronchiectasis, that defined as abnormal and permanent dilatation of bronchi. Bronchiectasis is associated with bronchial asthma in 2.7-42%. We studed the clinical significance of wheeze observed in bronchiectasis and interrelationships between the bronchiectasis with wheeze and bronchial asthma.
METHODS
We reviewed the 32 patients with bronchiectasis confirmed by HRCT. Exclusion criteria are acute exacerbation of bronchiectasis, neoplasm, bronchial asthma. The controlled group is 29 bronchial asthma patients and their diagnositc criteria is when the %change of FEV1 after inhaled bronchodilators is 12% or more and absolute change value is >or =200 mL. All patients were performed spirometry, bronchodilator test, bronchial hyperresponsiveness to methacholine, skin prick test and sputum analysis for cell counts.
RESULTS
The Wheeze observed in 43.7% of bronchiectasis patients. Wheeze group revealed the more obstructive pattern in spirometry than non-wheeze group (FEV1% 71.0+/-8.2% vs 91.7+/-5.5%, p=0.04; FEV1/FVC 61.1+/-4.4% vs 78.2+/-3.7%, p=0.009), more bronchodilator responses (8.4+/-2.1% vs 4.9+/-1.7%, p=0.045) and more bonchial hyperresponsiveness (positive results in PC20 : 2 in 6 patients vs no positive in 3 patients). Asthma control group has no significant differences with wheeze group. But compared with non-wheeze group, it has significantly decreased lung function (FEV1/FVC 65.5+/-2.9% vs 78.2+/-3.7, p=0.004), more bronchodilator responses (14.8+/-0.6% vs 4.9+/-1.7%, p=0.001) and more eosinophilic airway inflammations (sputum eosinphile% 11.4+/-2.0 vs 0.8+/-0.4, p=0.05).
CONCLUSIONS
The wheezes observed in bronchiectasis are associated with bronchial hyperres ponsiveness and eosinophilic airway inflammations.