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Effects of Air Pollutant Exposure on Exacerbation Severity in Asthma Patients with or without Reversible Airflow Obstruction

BACKGROUND: Reversible airflow obstruction (RO) and fixed airflow obstruction (FO) are two important clinical phenotypes of asthma. However, the relationship between air pollutant exposure and exacerbation of the two phenotypes is unknown. OBJECTIVE: To study the effects of air pollutant exposure on...

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Autores principales: Fang, Wei, Zhang, Yu, Li, Sinian, Liu, Aiming, Jiang, Yin, Chen, Dandan, Li, Binbin, Yao, Can, Chen, Rongchang, Shi, Fei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8454419/
https://www.ncbi.nlm.nih.gov/pubmed/34557000
http://dx.doi.org/10.2147/JAA.S328652
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author Fang, Wei
Zhang, Yu
Li, Sinian
Liu, Aiming
Jiang, Yin
Chen, Dandan
Li, Binbin
Yao, Can
Chen, Rongchang
Shi, Fei
author_facet Fang, Wei
Zhang, Yu
Li, Sinian
Liu, Aiming
Jiang, Yin
Chen, Dandan
Li, Binbin
Yao, Can
Chen, Rongchang
Shi, Fei
author_sort Fang, Wei
collection PubMed
description BACKGROUND: Reversible airflow obstruction (RO) and fixed airflow obstruction (FO) are two important clinical phenotypes of asthma. However, the relationship between air pollutant exposure and exacerbation of the two phenotypes is unknown. OBJECTIVE: To study the effects of air pollutant exposure on exacerbation severity in asthma patients with or without FO. METHODS: A total of 197 severe asthma patients were enrolled, and divided into two groups: the FO group (n=81) and the RO group (n=116). We collected the demographic data, laboratory parameters, pulmonary function test parameters, and the daily average concentrations of different air particles in Shenzhen on the different lag days of each subject. The receiver operating characteristic (ROC) curve was used to identify the effects of major air pollutants on the severity of asthma patients with RO. RESULTS: Compared with the RO group, the FO group had fewer women, lower body mass index (BMI), longer disease duration, higher smoking history rate, allergic family history rate, FeNO level, and lower levels of large airway parameters. The median exposure levels of PM10 and PM2.5 in the severe RO subgroup were both higher than those in the mild-to-moderate RO subgroup on Lag0, 1 and 3, and the median exposure level of PM1 on Lag0 in the severe RO subgroup was significantly higher than that in the mild-to-moderate RO subgroup. Logistic regression modeling indicated exposure to PM2.5 and PM1.0 on Lag0, and PM10 on Lag0-2 were the independent risk factors for hospital admissions for asthma patients with RO. By performing an ROC curve analysis, PM2.5 on Lag0 (AUC = 0.645, p = 0.027) provided a best performance to predict severe asthma exacerbations with RO, with a sensitivity of 36.0% and a specificity of 91.2%. CONCLUSION: Short-term exposure to PM10, PM2.5 and PM1 may play a role in exacerbation severity among asthma patients with RO.
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spelling pubmed-84544192021-09-22 Effects of Air Pollutant Exposure on Exacerbation Severity in Asthma Patients with or without Reversible Airflow Obstruction Fang, Wei Zhang, Yu Li, Sinian Liu, Aiming Jiang, Yin Chen, Dandan Li, Binbin Yao, Can Chen, Rongchang Shi, Fei J Asthma Allergy Original Research BACKGROUND: Reversible airflow obstruction (RO) and fixed airflow obstruction (FO) are two important clinical phenotypes of asthma. However, the relationship between air pollutant exposure and exacerbation of the two phenotypes is unknown. OBJECTIVE: To study the effects of air pollutant exposure on exacerbation severity in asthma patients with or without FO. METHODS: A total of 197 severe asthma patients were enrolled, and divided into two groups: the FO group (n=81) and the RO group (n=116). We collected the demographic data, laboratory parameters, pulmonary function test parameters, and the daily average concentrations of different air particles in Shenzhen on the different lag days of each subject. The receiver operating characteristic (ROC) curve was used to identify the effects of major air pollutants on the severity of asthma patients with RO. RESULTS: Compared with the RO group, the FO group had fewer women, lower body mass index (BMI), longer disease duration, higher smoking history rate, allergic family history rate, FeNO level, and lower levels of large airway parameters. The median exposure levels of PM10 and PM2.5 in the severe RO subgroup were both higher than those in the mild-to-moderate RO subgroup on Lag0, 1 and 3, and the median exposure level of PM1 on Lag0 in the severe RO subgroup was significantly higher than that in the mild-to-moderate RO subgroup. Logistic regression modeling indicated exposure to PM2.5 and PM1.0 on Lag0, and PM10 on Lag0-2 were the independent risk factors for hospital admissions for asthma patients with RO. By performing an ROC curve analysis, PM2.5 on Lag0 (AUC = 0.645, p = 0.027) provided a best performance to predict severe asthma exacerbations with RO, with a sensitivity of 36.0% and a specificity of 91.2%. CONCLUSION: Short-term exposure to PM10, PM2.5 and PM1 may play a role in exacerbation severity among asthma patients with RO. Dove 2021-09-16 /pmc/articles/PMC8454419/ /pubmed/34557000 http://dx.doi.org/10.2147/JAA.S328652 Text en © 2021 Fang et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Fang, Wei
Zhang, Yu
Li, Sinian
Liu, Aiming
Jiang, Yin
Chen, Dandan
Li, Binbin
Yao, Can
Chen, Rongchang
Shi, Fei
Effects of Air Pollutant Exposure on Exacerbation Severity in Asthma Patients with or without Reversible Airflow Obstruction
title Effects of Air Pollutant Exposure on Exacerbation Severity in Asthma Patients with or without Reversible Airflow Obstruction
title_full Effects of Air Pollutant Exposure on Exacerbation Severity in Asthma Patients with or without Reversible Airflow Obstruction
title_fullStr Effects of Air Pollutant Exposure on Exacerbation Severity in Asthma Patients with or without Reversible Airflow Obstruction
title_full_unstemmed Effects of Air Pollutant Exposure on Exacerbation Severity in Asthma Patients with or without Reversible Airflow Obstruction
title_short Effects of Air Pollutant Exposure on Exacerbation Severity in Asthma Patients with or without Reversible Airflow Obstruction
title_sort effects of air pollutant exposure on exacerbation severity in asthma patients with or without reversible airflow obstruction
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8454419/
https://www.ncbi.nlm.nih.gov/pubmed/34557000
http://dx.doi.org/10.2147/JAA.S328652
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