Asthma is characterized by airflow obstruction that is usually completely reversible either spontaneously or in response to treatment. However, a small subset of patients with asthma display FAO (fixed airflow obstruction) despite optimal treatment, a feature more commonly associated with smoking-induced COPD (chronic obstructive pulmonary disease). Why some asthma patients develop FAO is not understood, and it is not clear whether (i) they represent a subset of patients with more severe disease, (ii) they share some characteristics of patients who develop COPD, or (iii) they represent a different disease entity altogether. The present review compares the pulmonary inflammatory profile of asthma patients with FAO with those without FAO, as well as COPD sufferers. The inflammation in asthma patients with FAO can vary from neutrophilic with CD8 T-cell involvement, similar to that of COPD, to eosinophilic with CD4 Th2 cell involvement, akin to that of asthma patients without FAO. Although studies of FAO in asthma sufferers would benefit hugely from consistent inclusion criteria, further research work is also required to shed more light on the immunological processes involved.
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Review Article|
June 07 2011
Immunological basis of reversible and fixed airways disease
Carolyn Tubby;
Carolyn Tubby
*COPD Research Group, Department of Immunology, Nottingham Respiratory Biomedical Research Unit, University of Nottingham, Nottingham NG7 2UH, U.K.
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Tim Harrison;
Tim Harrison
†Department of Respiratory Medicine, Nottingham Respiratory Biomedical Research Unit, Nottingham City Hospital, Nottingham NG5 1PB, U.K.
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Ian Todd;
Ian Todd
*COPD Research Group, Department of Immunology, Nottingham Respiratory Biomedical Research Unit, University of Nottingham, Nottingham NG7 2UH, U.K.
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Lucy Fairclough
*COPD Research Group, Department of Immunology, Nottingham Respiratory Biomedical Research Unit, University of Nottingham, Nottingham NG7 2UH, U.K.
Correspondence: Dr Lucy Fairclough (email [email protected]).
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Publisher: Portland Press Ltd
Accepted:
May 05 2010
Received:
February 01 2011
Revision Received:
April 05 2011
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2011 Biochemical Society
2011
Clin Sci (Lond) (2011) 121 (7): 285–296.
Article history
Accepted:
May 05 2010
Received:
February 01 2011
Revision Received:
April 05 2011
Citation
Carolyn Tubby, Tim Harrison, Ian Todd, Lucy Fairclough; Immunological basis of reversible and fixed airways disease. Clin Sci (Lond) 1 October 2011; 121 (7): 285–296. doi: https://doi.org/10.1042/CS20110062
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