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Rupani H, Teague WG. Blood Eosinophil and Neutrophil Categories Can Differentiate Adult Asthma Phenotypes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:822-824. [PMID: 36894280 DOI: 10.1016/j.jaip.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 03/09/2023]
Affiliation(s)
- Hitasha Rupani
- Department of Respiratory Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
| | - W Gerald Teague
- Child Health Research Center, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Va
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Shimoda T, Obase Y, Nagasaka Y, Kishikawa R, Asai S. Lung Sound Analysis Provides A Useful Index For Both Airway Narrowing And Airway Inflammation In Patients With Bronchial Asthma. J Asthma Allergy 2019; 12:323-329. [PMID: 31632092 PMCID: PMC6781844 DOI: 10.2147/jaa.s216877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/18/2019] [Indexed: 11/23/2022] Open
Abstract
Background The expiration-to-inspiration sound power ratio in a midfrequency range (E/I MF), a parameter of lung sound analysis (LSA), has been reported to be useful as an index of airway inflammation in patients with bronchial asthma. However, the E/I MF reflects airway narrowing caused by airway inflammation, and there is thus concern that it may not be an index of airway eosinophilic inflammation itself. Methods A total of 131 patients with bronchial asthma were classified into four groups according to the presence or absence of airway narrowing and airway inflammation to examine whether the E/I MF could serve as an index of airway inflammation. Results The E/I MF was significantly higher in patients with a normal forced expiratory volume in one second (FEV1) and high fractional exhaled nitric oxide (FeNO), those with a low FEV1 and normal FeNO, and those with a low FEV1 and high FeNO than in those with a normal FEV1 and normal FeNO (p < 0.05–0.01). In particular, the E/I MF was high even in the patients who had no airway narrowing but had airway inflammation (p < 0.01). The results of multivariate analysis of factors involved in FeNO in patients with a normal FEV1 revealed that the E/I MF was an independent factor (p = 0.0281). Conclusion The E/I MF is a useful index of airway inflammation in the treatment of asthma, regardless of the presence or absence of airway narrowing.
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Affiliation(s)
- Terufumi Shimoda
- Department of Allergy, San Remo Rehabilitation Hospital, Sasebo, Japan.,Department of Allergy, Clinical Research Center, Fukuoka National Hospital, Fukuoka, Japan
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yukio Nagasaka
- Department of Respiratory Medicine, Kyoto Respiratory Center, Otowa Hospital, Kyoto, Japan
| | - Reiko Kishikawa
- Department of Allergy, Clinical Research Center, Fukuoka National Hospital, Fukuoka, Japan
| | - Sadahiro Asai
- Department of Allergy, San Remo Rehabilitation Hospital, Sasebo, Japan
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Fukumitsu T, Obase Y, Ishimatsu Y, Nakashima S, Ishimoto H, Sakamoto N, Nishitsuji K, Shiwa S, Sakai T, Miyahara S, Ashizawa K, Mukae H, Kozu R. The acoustic characteristics of fine crackles predict honeycombing on high-resolution computed tomography. BMC Pulm Med 2019; 19:153. [PMID: 31419981 PMCID: PMC6697909 DOI: 10.1186/s12890-019-0916-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 08/08/2019] [Indexed: 02/02/2023] Open
Abstract
Background Honeycombing on high-resolution computed tomography (HRCT) is a distinguishing feature of usual interstitial pneumonia and predictive of poor outcome in interstitial lung diseases (ILDs). Although fine crackles are common in ILD patients, the relationship between their acoustic features and honeycombing on HRCT has not been well characterized. Methods Lung sounds were digitally recorded from 71 patients with fine crackles and ILD findings on chest HRCT. Lung sounds were analyzed by fast Fourier analysis using a sound spectrometer (Easy-LSA; Fukuoka, Japan). The relationships between the acoustic features of fine crackles in inspiration phases (onset timing, number, frequency parameters, and time-expanded waveform parameters) and honeycombing in HRCT were investigated using multivariate logistic regression analysis. Results On analysis, the presence of honeycombing on HRCT was independently associated with onset timing (early vs. not early period; odds ratios [OR] 10.407, 95% confidence interval [95% CI] 1.366–79.298, P = 0.024), F99 value (the percentile frequency below which 99% of the total signal power is accumulated) (unit Hz = 100; OR 5.953, 95% CI 1.221–28.317, P = 0.029), and number of fine crackles in the inspiratory phase (unit number = 5; OR 4.256, 95% CI 1.098–16.507, P = 0.036). In the receiver-operating characteristic curves for number of crackles and F99 value, the cutoff levels for predicting the presence of honeycombing on HRCT were calculated as 13.2 (area under the curve [AUC], 0.913; sensitivity, 95.8%; specificity, 75.6%) and 752 Hz (AUC, 0.911; sensitivity, 91.7%; specificity, 85.2%), respectively. The multivariate logistic regression analysis additionally using these cutoff values revealed an independent association of number of fine crackles in the inspiratory phase, F99 value, and onset timing with the presence of honeycombing (OR 33.907, 95% CI 2.576–446.337, P = 0.007; OR 19.397, 95% CI 2.311–162.813, P = 0.006; and OR 12.383, 95% CI 1.443–106.293, P = 0.022; respectively). Conclusions The acoustic properties of fine crackles distinguish the honeycombing from the non-honeycombing group. Furthermore, onset timing, number of crackles in the inspiratory phase, and F99 value of fine crackles were independently associated with the presence of honeycombing on HRCT. Thus, auscultation routinely performed in clinical settings combined with a respiratory sound analysis may be predictive of the presence of honeycombing on HRCT.
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Affiliation(s)
- Toshikazu Fukumitsu
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yuji Ishimatsu
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan. .,Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan.
| | - Shota Nakashima
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kosei Nishitsuji
- Nagasaki University Graduate School of Engineering, 1-14 Bunkyo, Nagasaki, 852-8521, Japan
| | - Shunpei Shiwa
- Nagasaki University Graduate School of Engineering, 1-14 Bunkyo, Nagasaki, 852-8521, Japan
| | - Tomoya Sakai
- Nagasaki University Graduate School of Engineering, 1-14 Bunkyo, Nagasaki, 852-8521, Japan
| | - Sueharu Miyahara
- Nagasaki University Graduate School of Engineering, 1-14 Bunkyo, Nagasaki, 852-8521, Japan
| | - Kazuto Ashizawa
- Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Ryo Kozu
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan
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