title: Near fatal asthma: clinical and airway biopsy characteristics.
abstract: Background. Inflammation and remodeling are integral parts of asthma pathophysiology. We sought to describe the clinical and pathologic features of near fatal asthma exacerbation (NFE). Methods. Bronchial biopsies were collected prospectively from NFE I subjects. Another NFE II group and a moderate severity exacerbation control group (ME II) were retrospectively identified-no biopsies obtained. Results. All NFE II (n = 9) subjects exhibited remodeling and significant inflammation (eosinophilic, neutrophilic). NFE II group (n = 37) had a significant history of prior intubation and inhaled corticosteroids usage compared to ME II group (n = 41). They also exhibited leukocytosis, eosinophilia, and longer hospitalization days. Conclusions. Remodeling, eosinophilic, and neutrophilic inflammation were observed in NFE. NFE is associated with prior intubation and inhaled corticosteroids usage.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Barbers
authors.forename: Ilias C
authors.initials: IC
authors.lastname: Papanikolaou
authors.forename: Michael N
authors.initials: MN
authors.lastname: Koss
authors.forename: Ashish
authors.initials: A
authors.lastname: Patel
authors.forename: Elton
authors.initials: E
authors.lastname: Katagihara
authors.forename: Maggie
authors.initials: M
authors.lastname: Arenas
authors.forename: Khalid
authors.initials: K
authors.lastname: Chan
authors.forename: Colleen G
authors.initials: CG
authors.lastname: Azen
authors.forename: Om P
authors.initials: OP
authors.lastname: Sharma