Clinical and inflammatory characteristics of Asthma-COPD overlap in workers with occupational asthma

Iñigo Ojanguren, Gregory Moullec, Jad Hobeika, Marc Miravitlles, Catherine Lemiere, Iñigo Ojanguren, Gregory Moullec, Jad Hobeika, Marc Miravitlles, Catherine Lemiere

Abstract

Introduction: Although Asthma-COPD Overlap (ACO) has been described among populations of subjects with COPD or asthma, ACO has never been described among a population of subjects with occupational asthma (OA).

Objectives: The aims of this study were to: 1. identify ACO in a population of subjects with OA; and 2. compare the clinical characteristics between ACO and OA.

Methods: This retrospective study included all subjects diagnosed with OA between 2000 and 2017 in an OA referral center. Occupational Asthma-COPD Overlap (OACO) was defined as post-bronchodilator FEV1/FVC < 70% and smoking history ≥ 10 pack-years, along with a diagnosis of OA.

Results: Three hundred and four subjects were included, 262 (86.2%) were classified as OA and 42 (13.8%) as OACO. OA subjects presented higher sputum eosinophil counts after a specific-inhalation challenge than subjects with OACO (median [IQR]: 6.5 [17.0] vs 2.3 [3.5]). After adjusting for confounding factors, subjects with OACO were older (OR: 1.10 [1.05; 1.14]) and were taking higher doses of inhaled corticosteroids than OA subjects (OR, 5.20 [1.77; 16.48]). Subjects with OACO were less often atopic than OA subjects (OR, 0.19 [0.07; 0.62]).

Conclusions: Subjects with OACO constitute a distinct clinical and inflammatory phenotype from subjects with OA.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Study population.
Fig 1. Study population.
OA: occupational asthma; OACO: occupational asthma COPD overlap; FEV1: forced expiratory volume in the first second; FVC: forced vital capacity.
Fig 2. Sputum eosinophil and neutrophil counts…
Fig 2. Sputum eosinophil and neutrophil counts before and after SIC in OA and OACO patients.
OA: occupational asthma; OACO: occupational asthma COPD overlap; SIC: specific inhalation challenge.

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