title: Asthma Control and Airway Inflammation in Patients with Eosinophilic Granulomatosis with Polyangiitis.
abstract: Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis that occurs in patients with asthma, nasal disease, blood and tissue eosinophilia, and extrapulmonary manifestations.
  
  
  
  The aim of our study was to assess the clinical, functional, and inflammatory status of upper and lower airways in 37 patients with EGPA, examined 6.4 ± 4.7 years after diagnosis, when they were in partial or complete remission from systemic involvement while on treatment with low-dose oral corticosteroids as maintenance therapy.
  
  
  
  All patients performed spirometry and were assessed for bronchial hyperreactivity, sputum eosinophilia, and fractional exhaled nitric oxide; asthma control was evaluated according to the Global Initiative for Asthma (GINA) guidelines and the Asthma Control Test. Markers of systemic disease were compared with the data available at diagnosis. Nasal involvement was evaluated by using the Sino-Nasal Outcome Test, nasal endoscopy, and nasal cytology. The impact on the quality of life was evaluated by using generic (36-item short form health survey) and organ-specific questionnaires.
  
  
  
  At the time of the study visit, almost all patients were receiving low-dose oral corticosteroids and immunomodulating drugs, but only 50% were being treated with inhaled corticosteroids. Although low systemic disease activity was documented in the large majority of patients, poorly controlled asthma and rhinosinusitis with eosinophilic airway inflammation were demonstrated in almost all patients. A significant correlation was found between sputum and blood eosinophilia and between fractional exhaled nitric oxide and asthma control. The 36-item short form health survey questionnaire results significantly correlated with the Sino-Nasal Outcome Test but not with the Asthma Control Test.
  
  
  
  Systemic treatment controls systemic involvement in EGPA, but not asthma and nasal diseases, which negatively affects patients' quality of life.
authors.affiliation: Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy. Electronic address: manuela.latorre@yahoo.it.
authors.forename: Manuela
authors.initials: M
authors.lastname: Latorre
authors.affiliation: Rheumatology Unit, University Hospital of Pisa, Pisa, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Baldini
authors.affiliation: ENT Unit, University Hospital of Pisa, Pisa, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Seccia
authors.affiliation: Rheumatology Unit, University Hospital of Pisa, Pisa, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Pepe
authors.affiliation: Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Novelli
authors.affiliation: Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Celi
authors.affiliation: Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bacci
authors.affiliation: Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Cianchetti
authors.affiliation: Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy.
authors.forename: Federico L
authors.initials: FL
authors.lastname: Dente
authors.affiliation: Rheumatology Unit, University Hospital of Pisa, Pisa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bombardieri
authors.affiliation: Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Paggiaro
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D016207:Cytokines / Q000097:blood; D004802:Eosinophilia / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D011788:Quality of Life; D012220:Rhinitis / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D013147:Spirometry; D013183:Sputum / Q000166:cytology
chemical_list: D000305:Adrenal Cortex Hormones; D016207:Cytokines; D007155:Immunologic Factors; D009569:Nitric Oxide
keywords: Asthma; Eosinophilia; Granulomatosis; Inflammation; Nasal cytology; Rhinosinusitis; Sputum; Vasculitis