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Kakugawa T, Doi K, Ohteru Y, Kakugawa H, Oishi K, Kakugawa M, Hirano T, Mimura Y, Matsunaga K. Kinetics of COVID-19 mRNA primary and booster vaccine-associated neutralizing activity against SARS-CoV-2 variants of concern in long-term care facility residents: a prospective longitudinal study in Japan. Immun Ageing 2023; 20:42. [PMID: 37592283 PMCID: PMC10433614 DOI: 10.1186/s12979-023-00368-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/28/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) remains a threat to vulnerable populations such as long-term care facility (LTCF) residents, who are often older, severely frail, and have multiple comorbidities. Although associations have been investigated between COVID-19 mRNA vaccine immunogenicity, durability, and response to booster vaccination and chronological age, data on the association of clinical factors such as performance status, nutritional status, and underlying comorbidities other than chronological age are limited. Here, we evaluated the anti-spike IgG level and neutralizing activity against the wild-type virus and Delta and Omicron variants in the sera of LTCF residents, outpatients, and healthcare workers before the primary vaccination; at 8, 12, and 24 weeks after the primary vaccination; and approximately 3 months after the booster vaccination. This 48-week prospective longitudinal study was registered in the UMIN Clinical Trials Registry (Trial ID: UMIN000043558). RESULTS Of 114 infection-naïve participants (64 LTCF residents, 29 outpatients, and 21 healthcare workers), LTCF residents had substantially lower anti-spike IgG levels and neutralizing activity against the wild-type virus and Delta variant than outpatients and healthcare workers over 24 weeks after the primary vaccination. In LTCF residents, booster vaccination elicited neutralizing activity against the wild-type virus and Delta variant comparable to that in outpatients, whereas neutralizing activity against the Omicron variant was comparable to that in outpatients and healthcare workers. Multiple regression analyses showed that age was negatively correlated with anti-spike IgG levels and neutralizing activity against the wild-type virus and Delta variant after the primary vaccination. However, multivariate regression analysis revealed that poor performance status and hypoalbuminemia were more strongly associated with a lower humoral immune response than age, number of comorbidities, or sex after primary vaccination. Booster vaccination counteracted the negative effects of poor performance status and hypoalbuminemia on the humoral immune response. CONCLUSIONS LTCF residents exhibited suboptimal immune responses following primary vaccination. Although older age is significantly associated with a lower humoral immune response, poor performance status and hypoalbuminemia are more strongly associated with a lower humoral immune response after primary vaccination. Thus, booster vaccination is beneficial for older adults, especially those with a poor performance status and hypoalbuminemia.
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Affiliation(s)
- Tomoyuki Kakugawa
- Department of Pulmonology and Gerontology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, 755-8505, Ube, Yamaguchi, Japan.
- Department of Internal Medicine, Medical Corporation WADOKAI Hofu Rehabilitation Hospital, Hofu, Japan.
- Department of Respiratory Medicine, National Hospital Organization Yamaguchi Ube Medical Center, Ube, Japan.
| | - Keiko Doi
- Department of Pulmonology and Gerontology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, 755-8505, Ube, Yamaguchi, Japan
| | - Yuichi Ohteru
- Department of Internal Medicine, Medical Corporation WADOKAI Hofu Rehabilitation Hospital, Hofu, Japan
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Hiroyuki Kakugawa
- Department of Internal Medicine, Medical Corporation WADOKAI Hofu Rehabilitation Hospital, Hofu, Japan
| | - Keiji Oishi
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Masahiro Kakugawa
- Department of Internal Medicine, Medical Corporation WADOKAI Hofu Rehabilitation Hospital, Hofu, Japan
| | - Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Yusuke Mimura
- The Department of Clinical Research, National Hospital Organization Yamaguchi Ube Medical Center, Ube, Japan
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Japan
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Ohteru Y, Hamada K, Oishi K, Suizu J, Harada M, Murakawa K, Chikumoto A, Matsuda K, Uehara S, Ohata S, Murata Y, Yamaji Y, Sakamoto K, Asami-Noyama M, Edakuni N, Hirano T, Kakugawa T, Murakami T, Takemura T, Matsunaga K. Antineutrophil cytoplasmic antibody-negative granulomatosis with polyangiitis localized to the lungs. Respir Med Case Rep 2022; 36:101600. [PMID: 35169540 PMCID: PMC8829757 DOI: 10.1016/j.rmcr.2022.101600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 12/30/2021] [Accepted: 01/31/2022] [Indexed: 11/04/2022] Open
Abstract
Patients with granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, sometimes exhibit no clinical features. Here, we describe a case of antineutrophil cytoplasmic antibody (ANCA)-negative GPA presenting with only lung granuloma. A 55-year-old woman with a right upper lung mass underwent lobectomy for suspected lung cancer; however, only granuloma was detected, and the etiology was not identified. Serum ANCA results were negative. Four years postoperatively, another pulmonary nodule appeared in the left lung's apex. The kidneys and sinuses were not impaired, but re-examination of the resected specimen revealed necrotizing vasculitis and granulomas around the vessels. Thus, the patient was diagnosed with GPA localized to the lungs. Although this was a non-life-threatening disease, the patient was administered oral prednisolone (PSL) and intravenous cyclophosphamide (IVCY) to prevent fatal complications of GPA as she was non-elderly and had no comorbidities, leading to a decrease in the mass size. Detailed re-examination by expert pulmonary pathologists could aid in GPA diagnosis when clinical features are absent, as in our case. In patients with granulomas of unknown etiology, a careful multidisciplinary approach is pivotal in the diagnosis. If patients tolerate adverse effects, a PSL and IVCY combination may prevent fatal outcomes, even in patients with non-life-threatening disease.
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Hirano T, Matsunaga K, Oishi K, Doi K, Harada M, Suizu J, Murakawa K, Chikumoto A, Ohteru Y, Matsuda K, Uehara S, Hamada K, Ohata S, Murata Y, Yamaji Y, Asami-Noyama M, Edakuni N. Abundant TNF-LIGHT expression in the airways of patients with asthma with persistent airflow limitation: Association with nitrative and inflammatory profiles. Respir Investig 2021; 59:651-660. [PMID: 34244107 DOI: 10.1016/j.resinv.2021.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/12/2021] [Accepted: 05/22/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND The role of the inflammatory secretory protein TNF-LIGHT (LIGHT) in the molecular mechanisms underlying persistent airflow limitation (PAL) in asthma remains unclear. We hypothesized that high airway LIGHT expression may be a feature of asthma with PAL associated with specific expression patterns of inflammatory molecules. METHODS This hypothesis was tested in 16 patients with asthma on inhaled corticosteroid treatment. Induced sputum was collected, the expression of LIGHT and 3-nitrotyrosine (NT), which reflects the footprint of reactive nitrogen species content, was measured using immunohistochemical staining, and the inflammatory molecules in the sputum supernatant were analyzed using a magnetic bead array. RESULTS LIGHT staining in the cells had a significantly higher intensity in participants with PAL than in participants without PAL (47.9 × 104/ml vs. 5.4 × 104/ml; p < 0.05). The array analysis indicated that IL-8, IL-19, matrix metalloproteinase 2, and osteopontin, were associated with high LIGHT immunoreactivity. The fractionation of 3-NT-positive cells was positively correlated with that of LIGHT-positive cells (r = 0.57, p < 0.05) and the TGF-β1 level (r = 0.61, p < 0.05). LIGHT- and 3-NT-positive cells showed significant positive correlation with the differential cell counts of neutrophils, macrophages, and eosinophils in the induced sputum. Intense immunoreactivities of LIGHT (r = -0.54, p < 0.05) and 3-NT (r = -0.42, p = 0.1) were negatively associated with decreased forced expiratory volume in 1/forced vital capacity ratio. CONCLUSIONS The findings suggest that LIGHT is a key component in the association between airway inflammation and airflow limitation in patients with asthma, and its expression may be persistently correlated with the abundance of inflammatory cells and inflammatory and profibrogenic radical/molecules.
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Affiliation(s)
- Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan.
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Keiji Oishi
- Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Keiko Doi
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Misa Harada
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Junki Suizu
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Keita Murakawa
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Ayumi Chikumoto
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Yuichi Ohteru
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Kazuki Matsuda
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Sho Uehara
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Kazuki Hamada
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Shuichiro Ohata
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Yoriyuki Murata
- Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Yoshikazu Yamaji
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Maki Asami-Noyama
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
| | - Nobutaka Edakuni
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, 755-8505, Japan
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Hirano T, Doi K, Matsunaga K, Takahashi S, Donishi T, Suga K, Oishi K, Yasuda K, Mimura Y, Harada M, Suizu S, Murakawa K, Chikumoto A, Ohteru Y, Matsuda K, Uehara S, Hamada K, Ohata S, Murata Y, Yamaji Y, Asami-Noyama M, Edakuni N, Kakugawa T. A Novel Role of Growth Differentiation Factor (GDF)-15 in Overlap with Sedentary Lifestyle and Cognitive Risk in COPD. J Clin Med 2020; 9:E2737. [PMID: 32847145 PMCID: PMC7565594 DOI: 10.3390/jcm9092737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 12/18/2022] Open
Abstract
Sedentary behavior and cognitive impairment have a direct impact on patients' outcomes. An energy metabolic disorder may be involved in the overlap of these comorbid conditions (motoric cognitive risk (MCR)) in patients with chronic obstructive pulmonary disease (COPD). We aimed to explore the linkage between a proapoptotic protein, growth differentiation factor (GDF)-15, and MCR. Physical activity (PA), cognitive function (Japanese version of the Montreal Cognitive Assessment: MOCA-J), and the serum GDF-15 levels were assessed in healthy subjects (n = 14), asthmatics (n = 22), and COPD patients (n = 28). In the entire cohort, serum GDF-15 had negative correlations with exercise (Ex) (ρ = -0.43, p < 0.001) and MoCA-J (ρ = -0.44, p < 0.001), and Ex and MOCA-J showed a positive correlation (ρ = 0.52, p < 0.0001). Compared to healthy subjects and asthmatics, COPD patients showed the highest serum GDF-15 levels and had a significantly higher proportion of subjects with MCR (both sedentary lifestyle (EX < 1.5) and cognitive risk (MoCA-J ≤ 25)). Also, we found that serum GDF-15 has a screening potential (100% sensitivity) greater than aging (67% sensitivity) for detecting MCR in COPD patients. In conclusion, higher serum GDF-15 had interrelationships with a sedentary lifestyle and cognitive risk. This protein was not disease-specific but could be a screening biomarker to detect MCR related to poor health outcomes of COPD patients.
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Affiliation(s)
- Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Keiko Doi
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Shun Takahashi
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama 641-8510, Japan; (S.T.); (K.Y.)
| | - Tomohiro Donishi
- Department of System Neurophysiology, Graduate School of Wakayama Medical University, Wakayama 641-8510, Japan;
| | - Kazuyoshi Suga
- Department of Radiology, Semui PET Screening and Radiatiotherapeutic Site, St. Hill Hospital, Ube 755-0155, Japan;
| | - Keiji Oishi
- Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.O.); (Y.M.)
| | - Kasumi Yasuda
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama 641-8510, Japan; (S.T.); (K.Y.)
| | - Yusuke Mimura
- Department of Clinical Research, National Hospital Organization Yamaguchi Ube Medical Center, Ube 755-0241, Japan;
| | - Misa Harada
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Sumiteru Suizu
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Keita Murakawa
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Ayumi Chikumoto
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Yuichi Ohteru
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Kazuki Matsuda
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Sho Uehara
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Kazuki Hamada
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Shuichiro Ohata
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Yoriyuki Murata
- Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.O.); (Y.M.)
| | - Yoshikazu Yamaji
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Maki Asami-Noyama
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Nobutaka Edakuni
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan; (K.D.); (K.M.); (M.H.); (S.S.); (K.M.); (A.C.); (Y.O.); (K.M.); (S.U.); (K.H.); (S.O.); (Y.Y.); (M.A.-N.); (N.E.)
| | - Tomoyuki Kakugawa
- Department of Pulmonology and Gerontology Graduate School of Medicine, Yamaguchi University, Ube 755-8505, Japan;
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Yamaji Y, Oishi K, Hamada K, Ohteru Y, Chikumoto A, Murakawa K, Matsuda K, Suetake R, Murata Y, Ito K, Asami-Noyama M, Edakuni N, Hirano T, Matsunaga K. Detection of type2 biomarkers for response in COPD. J Breath Res 2020; 14:026007. [DOI: 10.1088/1752-7163/ab71a4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Hamada K, Oishi K, Chikumoto A, Murakawa K, Ohteru Y, Matsuda K, Uehara S, Suetake R, Ohata S, Murata Y, Yamaji Y, Asami-Noyama M, Ito K, Edakuni N, Hirano T, Matsunaga K. Impact of sinus surgery on type 2 airway and systemic inflammation in asthma. J Asthma 2020; 58:750-758. [PMID: 32050820 DOI: 10.1080/02770903.2020.1729380] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objective: Asthma is frequently associated with chronic rhinosinusitis with nasal polyps (CRSwNP). Although endoscopic sinus surgery (ESS) improves asthma control in CRSwNP patients with asthma, the mechanism that underlies the response to surgical treatment is still unclear. We evaluated the relevance of changes in asthma control and changes in airway/systemic inflammation in eosinophilic CRSwNP patients with not well controlled asthma who underwent ESS.Methods: We prospectively assessed changes in the asthma control questionnaire (ACQ) score, blood eosinophil counts (B-Eos), forced expiratory volume in 1 s (FEV1), and fraction of exhaled nitric oxide (FeNO) levels at 1-week before and 8 and 52 weeks after ESS.Results: Twenty-five subjects were analyzed. The ACQ score, B-Eos, and FeNO decreased, and FEV1 increased significantly after ESS. In the period from baseline to 52 weeks after ESS, changes in ACQ were significantly correlated with the changes in blood eosinophil counts (r = 0.58, p<.01) and FeNO (r = 0.45, p<.05). Ten subjects (40%) showed consistently improved asthma control at 52-weeks after ESS. In the remaining subjects, although the ACQ score temporarily improved at 8-weeks after ESS, but eventually deteriorated at 52-weeks. Higher levels of total immunoglobulin E were associated with long-term improved asthma control after ESS.Conclusions: In eosinophilic CRSwNP patients with asthma, sinus surgery impacts asthma control through the suppression of airway/systemic type 2 inflammation. The present study reinforced the common pathophysiology of type 2 inflammation between the upper and lower airways.
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Affiliation(s)
- Kazuki Hamada
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Keiji Oishi
- Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Ayumi Chikumoto
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Keita Murakawa
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Yuichi Ohteru
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Kazuki Matsuda
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Sho Uehara
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Ryo Suetake
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Shuichiro Ohata
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Yoriyuki Murata
- Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Yoshikazu Yamaji
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Maki Asami-Noyama
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Kosuke Ito
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Nobutaka Edakuni
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
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