https://doi.org/10.4081/monaldi.2025.3116
Trajectory of the response to bronchodilator and respiratory outcomes in adults with asthma-like symptoms
Submitted: July 3, 2024
Accepted: January 9, 2025
Published: March 17, 2025
Accepted: January 9, 2025
Abstract Views: 149
PDF_EARLY VIEW: 61
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
In the real world, health professionals need to care for individuals with asthma-like symptoms who have a persistently negative bronchodilator response (BDR). Little is known about the evolution of symptoms and lung function of these individuals because they are usually excluded from studies on asthma. The aim of this study was to evaluate whether individuals with asthma-like symptoms but with a persistently negative BDR have a different evolution of symptoms and lung function compared to individuals with asthma proven by positive BDR. This prospective cohort study included adults with asthma-like symptoms. Individuals participated in two visits 12 months apart. They responded to questionnaires and underwent a spirometry test. In individuals without airway obstruction in the first visit, those with asthma-like symptoms and persistently negative BDR were less likely to lose forced expiratory volume in the first second during follow-up or progress to airway obstruction at the final visit compared to individuals with asthma proven by positive BDR. Among individuals with airway obstruction at baseline, those with asthma-like symptoms and persistently negative BDR were less likely to resolve the airway obstruction during follow-up compared to individuals with asthma proven by positive BDR. In individuals with proven asthma, the emergence or persistence of positive BDR during follow-up was accompanied by a worsening of asthma outcomes compared to the remission of positive BDR. Thus, BRD is an accessible marker of disease progression in individuals with asthma-like symptoms. In individuals with asthma proven by positive BDR, the trend in BDR was associated with the evolution of symptoms and lung function.
Ijpma G, Kachmar L, Matusovsky OS, et al. Human trachealis and main bronchi smooth muscle are normoresponsive in asthma. Am J Respir Crit Care Med 2015;191:884-93.
DOI: https://doi.org/10.1164/rccm.201407-1296OC
Khan MA. Inflammation signals airway smooth muscle cell proliferation in asthma pathogenesis. Multidiscip Respir Med 2013;8:11.
DOI: https://doi.org/10.1186/2049-6958-8-11
Regamey N, Ochs M, Hilliard TN, et al. Increased airway smooth muscle mass in children with asthma, cystic fibrosis, and non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med 2008;177:837-43.
DOI: https://doi.org/10.1164/rccm.200707-977OC
Muniz IS, Ponte EV, Lima VB, Cruz ÁA. Irreversible airway obstruction in asthma: a risk factor for severe exacerbations in spite of proper treatment. J Asthma 2016;53;801-7.
DOI: https://doi.org/10.3109/02770903.2016.1155220
Reddel HK, Bacharier LB, Bateman ED, et al. Global Initiative for Asthma Strategy 2021: executive summary and rationale for key changes. Eur Respir J 2021;59:2102730.
DOI: https://doi.org/10.1183/13993003.02730-2021
Janson C, Malinovschi A, Amaral AFS, et al. Bronchodilator reversibility in asthma and COPD: findings from three large population studies. Eur Respir J 2019;54:1900561.
DOI: https://doi.org/10.1183/13993003.00561-2019
Cavallazzi RS, Polivka BJ, Beatty BL, et al. Current bronchodilator responsiveness criteria underestimate asthma in older adults. Respir Care 2020;65:1104-11.
DOI: https://doi.org/10.4187/respcare.07132
Currie GP, Fowler SJ, Lipworth BJ. Dose response of inhaled corticosteroids on bronchial hyperresponsiveness: a meta-analysis. Ann Allergy Asthma Immunol 2003;90:194-8.
DOI: https://doi.org/10.1016/S1081-1206(10)62140-0
Puckett JL, Taylor RW, Leu SY, et al. An elevated bronchodilator response predicts large airway inflammation in mild asthma. Pediatr Pulmonol 2010;45:174-81.
DOI: https://doi.org/10.1002/ppul.21172
Goleva E, Hauk PJ, Boguniewicz J, et al. Airway remodeling and lack of bronchodilator response in steroid-resistant asthma. J Allergy Clin Immunol 2007;120:1065-72.
DOI: https://doi.org/10.1016/j.jaci.2007.07.042
Roxo JP, Ponte EV, Ramos DC, et al. Portuguese-language version of the asthma control test. J Bras Pneumol 2010;36:159-66. [Article in Portuguese].
DOI: https://doi.org/10.1590/S1806-37132010000200002
Theodoro EE, Rocha DGD, Bertolino JR, et al. Evaluating the effect of antidepressants on the relationship between depression and asthma. Respir Med 2023;207:107099.
DOI: https://doi.org/10.1016/j.rmed.2022.107099
Silva JN, Rocha A, de Souza IA, et al. Does peripheral blood eosinophil count predict lung function improvement in adult individuals with asthma? Ann Allergy Asthma Immunol 2021;127:388-9.
DOI: https://doi.org/10.1016/j.anai.2021.05.024
Almeida PC, Ponte EV, Souza-Machado A, Cruz AA. Longitudinal trends in clinical characteristics and lung function of patients with severe asthma under treatment in Brazil. BMC Pulm Med 2016;16:141.
DOI: https://doi.org/10.1186/s12890-016-0302-5
Wei J, Ma L, Wang J, et al. Airway reversibility in asthma and phenotypes of Th2 biomarkers, lung function and disease control. Allergy Asthma Clin Immunol 2018;14:89.
DOI: https://doi.org/10.1186/s13223-018-0315-0
Ponte EV, Lima A, Almeida PCA, et al. Age is associated with asthma phenotypes. Respirology 2017;22:1558-63.
DOI: https://doi.org/10.1111/resp.13102
Ponte EV, Stelmach R, Franco R, et al. Age is not associated with hospital admission or uncontrolled symptoms of asthma if proper treatment is offered. Int Arch Allergy Immunol 2014;165:61-7.
DOI: https://doi.org/10.1159/000367924
Bezerra de Menezes M, Ponte EV, Bertagni Mingotti CF, et al. Provision of inhaled corticosteroids is associated with decrease in hospital admissions in Brazil: a longitudinal nationwide study. Respir Med 2020;166:105950.
DOI: https://doi.org/10.1016/j.rmed.2020.105950
Ponte EV, Rocha DGD, Guinossi RM, et al. Evaluating the relationship between the type of rescue medication and the adequacy of asthma maintenance therapy. Respir Med 2023;217:107364.
DOI: https://doi.org/10.1016/j.rmed.2023.107364
Denlinger LC, Phillips BR, Ramratnam S, et al. Inflammatory and Comorbid Features of Patients with Severe Asthma and Frequent Exacerbations. Am J Respir Crit Care Med 2017;195:302-13.
DOI: https://doi.org/10.1164/rccm.201602-0419OC
Nuijsink M, Hop WC, Sterk PJ, et al. Long-term asthma treatment guided by airway hyperresponsiveness in children: a randomised controlled trial. Eur Respir J 2007;30:457-66.
DOI: https://doi.org/10.1183/09031936.00111806
Sont JK, Willems LN, Bel EH, et al. Clinical control and histopathologic outcome of asthma when using airway hyperresponsiveness as an additional guide to long-term treatment. The AMPUL Study Group. Am J Respir Crit Care Med 1999;159:1043-51.
DOI: https://doi.org/10.1164/ajrccm.159.4.9806052
Ashenhurst JR, Nhan H, Shelton JF, et al. Prevalence of alpha-1 antitrypsin deficiency, self-reported behavior change, and health care engagement among direct-to-consumer recipients of a personalized genetic risk report. Chest 2022;161:373-81.
DOI: https://doi.org/10.1016/j.chest.2021.09.041
Stanojevic S, Kaminsky DA, Miller MR, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J 2022;60:2101499.
DOI: https://doi.org/10.1183/13993003.01499-2021
Ethics Approval
The institutional review board of the Jundiaí School of Medicine approved the study, approval number 5.221.754.How to Cite
Gimenez da Rocha, Daniel, Monique Olivia Burch, Luciana Aparecida Teixeira Soares, Jessica Regina Bertolino, Ana Lúcia Bergamasco Galastri, Daniel Antunes, Ronei Luciano Mamoni, and Eduardo Vieira Ponte. 2025. “Trajectory of the Response to Bronchodilator and Respiratory Outcomes in Adults With Asthma-Like Symptoms”. Monaldi Archives for Chest Disease, March. https://doi.org/10.4081/monaldi.2025.3116.
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