Malo JL, L'archevêque J, Castellanos L, Lavoie K, Ghezzo H, Maghni K
The long-term outcomes of acute irritant-induced asthma (IIA) are mostly unknown.
To study the long-term outcomes of IIA.
We reassessed 35 subjects who experienced IIA at a mean interval of 13.6 +/- 5.2 years.
MEASUREMENTS AND MAIN RESULTS:
The causal agent was chlorine in 20 cases (57%). At diagnosis, the mean +/- SD FEV(1) was 74.5 +/- 19.5% predicted, and all subjects showed bronchial hyperresponsiveness. At reassessment, all subjects reported respiratory symptoms, and 24 (68%) were on inhaled steroids. There were no significant improvements in FEV(1) and FEV(1)/FVC values. Twenty-three subjects had a methacholine test, and only six subjects had normal levels of responsiveness. Of the remaining 12 subjects, six had improvement in FEV(1) after bronchodilator>or=10%. In samples of induced sputum obtained from 27 subjects, six had eosinophils>or=2%. Levels of inflammatory and remodeling mediators were higher than in control subjects but wereno different from subjects with occupational asthma due to sensitization. Quality of life score was 4.4 +/- 1.5 on a 0 (worst) to 7 (best) scale. Twelve subjects had an abnormal depression score.
This study provides the first evidence of significant long-term impact of acute IIA on various outcomes.
Axe de Recherche en SantéRespiratoire, Hôpital du Sacré-Coeur de Montréal, Quebec. firstname.lastname@example.org