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Original Research: Signs and Symptoms of Chest Disease |

Will Nonasthmatic Eosinophilic Bronchitis Develop Into Chronic Airway Obstruction?Prognosis of Eosinophilic Bronchitis: A Prospective, Observational Study

Kefang Lai, MD, PhD; Baojuan Liu, MD, PhD; Danyuan Xu, MD; Lina Han, MD; Ling Lin, MD; Yin Xi, MD; Faxia Wang, MD; Ruchong Chen, MD, PhD; Wei Luo, MD; Qiaoli Chen, MD; Nanshan Zhong, MD
Author and Funding Information

From the State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

CORRESPONDENCE TO: Kefang Lai, MD, PhD, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Rd, Guangzhou 510120, China; e-mail: klai@163.com


FOR EDITORIAL COMMENT SEE PAGE 844

FUNDING/SUPPORT: The study was supported by the National Key Technologies R&D Program [2012BAI05B00] and National Natural Science Foundation [81070019].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(4):887-894. doi:10.1378/chest.14-2351
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OBJECTIVE:  The long-term prognosis of nonasthmatic eosinophilic bronchitis (NAEB) is still unclear. The aim of this study was to observe the frequency of relapse among patients with NAEB and the likelihood of NAEB developing into chronic airflow obstruction over time.

METHODS:  Patients with NAEB were followed for at least 1 year between 2003 and 2013. During this period, we evaluated clinical symptoms, sputum eosinophil count, spirometry, and bronchial hyperresponsiveness. A linear mixed model was adopted to determine the relationship between time and lung function.

RESULTS:  A total of 234 patients with NAEB were identified, of whom 141 were followed for > 1 year (median, 4.1 years). Up to 59.6% of patients had a relapse after treatment. Both allergic rhinitis (OR, 4.37; 95% CI, 1.049-18.203; P = .043) and sputum eosinophilia after 4 weeks of treatment with inhaled corticosteroids (OR, 9.493; 95% CI, 2.381-37.850; P = .001) were risk factors for relapse. Among the 141 patients, mild asthma developed in eight (5.7%). During the follow-up period, no progressive decline in FVC, FEV1, and FEV1/FVC were observed (P > .05). Although the proportion of small airway dysfunction (maximum midexpiratory flow [MMEF] < 65%) significantly increased at the last visit in all groups (all P < .05), only the relapse group showed an MMEF decline at the end of follow-up (P < .05) in the linear mixed model.

CONCLUSIONS:  More than 50% of patients with NAEB have repeated episodes associated with persistent sputum eosinophilia after treatment and allergic rhinitis. In the current cohort, chronic airway obstruction does not develop despite small airway dysfunction increases over time.

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