Acute severe asthma: viruses and eosinophilic cationic protein
Acute severe asthma: viruses and eosinophilic cationic protein
This thesis studied a cohort of asthmatics admitted to hospital at the time of an acute exacerbation of their asthma. There were 3 aims: To describe the characteristics of the subjects and determine which are important as prognostic indicators. To investigate the role of non bacterial pathogens as precipitants of acute severe asthma and to investigate the usefulness of serum eosinophilic cationic protein (ECP) as a marker of asthma severity.
Logistic regression showed that respiratory rate, baseline spirometry and response to bronchodilators were important factors relating to outcome at follow up. 27% of subjects were current smokers and the duration of hospital stay was shorter for them than non-smokers (2 vs 3.5 days, p=0.0089). Possibly the asthmatics with the most sensitive airways are least likely to smoke thus it is only the healthier asthmatics who can tolerate the effects of smoking.
Viruses were detected in 19% of acute and in 2% of convalescent samples. Virus shedding is reduced after the first few days of a URTI. For those samples collected within 3 days of the onset of URTI the virus detection rate was 49%. Hospital admissions with asthma and virus detection peaked in the late spring. Viral infections are relatively rare in the late spring suggesting that a cofactor must be important acting in tandem with the viral infection. In contrast virus infection appears to be less important for the subgroup of chronic severe persistent steroid dependent asthmatics, virus isolation 2.5% of episodes.
Finally this study looked at ECP as a marker of asthma severity. Neither serum ECP nor serum ECP corrected for the total number of eosinophils were good markers of asthma. They did not correlate with PEF% and high levels did not predict future falls in PEF. Currently this study does not support the use of serum ECP or ECP/Eos levels in the assessment of asthma.
University of Southampton
1999
Chanarin, Nicholas
(1999)
Acute severe asthma: viruses and eosinophilic cationic protein.
University of Southampton, Doctoral Thesis.
Record type:
Thesis
(Doctoral)
Abstract
This thesis studied a cohort of asthmatics admitted to hospital at the time of an acute exacerbation of their asthma. There were 3 aims: To describe the characteristics of the subjects and determine which are important as prognostic indicators. To investigate the role of non bacterial pathogens as precipitants of acute severe asthma and to investigate the usefulness of serum eosinophilic cationic protein (ECP) as a marker of asthma severity.
Logistic regression showed that respiratory rate, baseline spirometry and response to bronchodilators were important factors relating to outcome at follow up. 27% of subjects were current smokers and the duration of hospital stay was shorter for them than non-smokers (2 vs 3.5 days, p=0.0089). Possibly the asthmatics with the most sensitive airways are least likely to smoke thus it is only the healthier asthmatics who can tolerate the effects of smoking.
Viruses were detected in 19% of acute and in 2% of convalescent samples. Virus shedding is reduced after the first few days of a URTI. For those samples collected within 3 days of the onset of URTI the virus detection rate was 49%. Hospital admissions with asthma and virus detection peaked in the late spring. Viral infections are relatively rare in the late spring suggesting that a cofactor must be important acting in tandem with the viral infection. In contrast virus infection appears to be less important for the subgroup of chronic severe persistent steroid dependent asthmatics, virus isolation 2.5% of episodes.
Finally this study looked at ECP as a marker of asthma severity. Neither serum ECP nor serum ECP corrected for the total number of eosinophils were good markers of asthma. They did not correlate with PEF% and high levels did not predict future falls in PEF. Currently this study does not support the use of serum ECP or ECP/Eos levels in the assessment of asthma.
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Published date: 1999
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Local EPrints ID: 463619
URI: http://eprints.soton.ac.uk/id/eprint/463619
PURE UUID: 1525890f-32c1-472f-9599-1696afbb4fe9
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Date deposited: 04 Jul 2022 20:54
Last modified: 04 Jul 2022 20:54
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Author:
Nicholas Chanarin
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