Chronic cough and sputum production are associated with worse clinical outcomes in stable asthma

Thomson, N.C., Chaudhuri, R. , Messow, C.M. , Spears, M., MacNee, W., Connell, M., Murchison, J.T., Sproule, M. and McSharry, C. (2013) Chronic cough and sputum production are associated with worse clinical outcomes in stable asthma. Respiratory Medicine, 107(10), pp. 1501-1508. (doi: 10.1016/j.rmed.2013.07.017)

[img]
Preview
Text
87981.pdf - Published Version

580kB

Abstract

Background: Chronic cough and sputum production (chronic mucus hypersecretion) is a poorly described clinical feature of asthma. Our objective was to identify clinical, immunological and computed tomography (CT) measures of airway wall dimensions associated with these symptoms in smokers and never smokers with asthma.<p></p> Methods: Cross-sectional data was analysed from 120 smokers and never smokers with asthma. Participants with and without a history of chronic mucus hypersecretion were compared for clinical outcomes, sputum differential cell counts and CT measures of airway dimensions (wall thickness, luminal area and percent wall area).<p></p> Results: Chronic mucus hypersecretion occurred in a higher proportion of smokers with asthma (56%) than never smokers with asthma (20%), (p < 0.001) and the proportion of patients with these symptoms increased with asthma severity (p = 0.003). Smokers with asthma and chronic mucus hypersecretion had worse current clinical control than smokers without those symptoms [ACQ score 2.3 versus 1.6, p = 0.002]. A greater proportion of never smokers with chronic mucus hypersecretion required short courses of oral corticosteroids in the last year (58% versus 19%, p = 0.011). Sputum neutrophil and eosinophil counts were similar in asthma patients with or without chronic mucus hypersecretion. Of those with severe asthma and chronic mucus hypersecretion, a CT measure of airway lumen area was reduced in smokers compared to never smokers (11.4 mm2 versus 18.4 mm2; p = 0.017).<p></p> Conclusions: Chronic mucus hypersecretion occurs frequently in adults with stable asthma, particularly in smokers with severe disease and is associated with worse current clinical control in smokers and more exacerbations in never smokers.<p></p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:MacNee, Prof William and Messow, Dr Martina and Thomson, Professor Neil and Spears, Dr Mark and Chaudhuri, Dr Rekha and McSharry, Dr Charles
Authors: Thomson, N.C., Chaudhuri, R., Messow, C.M., Spears, M., MacNee, W., Connell, M., Murchison, J.T., Sproule, M., and McSharry, C.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > School of Infection & Immunity
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Respiratory Medicine
Publisher:Elsevier Ltd
ISSN:0954-6111
ISSN (Online):1532-3064
Copyright Holders:Copyright © 2013 Elsevier Ltd.
First Published:First published in Respiratory Medicine 107(10):1501-1508
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

University Staff: Request a correction | Enlighten Editors: Update this record