Does airway hyperresponsiveness monitoring lead to improved asthma control?

The current guidelines recommend an approach to asthma management based on asthma control, rather than asthma severity. Although several specific questionnaires have been developed and control criteria have been established based on clinical guidelines, the evaluation of asthma control is still not optimal. In general, these indicators provide adequate assessment of current control, but they are more limited when estimating future risk. There is much evidence demonstrating the persistence of airway inflammation and airway hyperresponsiveness (AHR) in patients with total control. Therefore, the objective of this review was to analyse the possible role of AHR monitoring as an instrument for assessing asthma control. We will evaluate its capacity as an indicator for future risk, both for estimating the possibility of clinical deterioration and loss of lung function or exacerbations. Furthermore, its relationship with inhaled corticosteroid treatment will be analysed, while emphasizing its capacity for predicting response and adjusting dosage, as well as information about the capability of AHR for monitoring treatment. Last of all, we will discuss the main limitations and emerging opportunities of AHR as an assessment instrument for asthma control.

[Non-tuberculous mycobacterial infection in patients with non-cystic fibrosis bronchiectasias]. / Infección por micobacterias no tuberculosas en pacientes con bronquiectasias no causadas por fibrosis quística.

AIMS: To know the characteristics and prevalence of non-tuberculous mycobacterial infection infection in patients with non-cystic fibrosis bronchiectasis. PATIENTS AND METHODS: A retrospective descriptive study of NCFB adult patients whose disease had been followed-up for at least two years was performed. RESULTS: A total of 68 subjects were included, 50 females (73.5%), with mean age of 63.31± 16.2 years. The most frequent etiology of the non-cystic fibrosis bronchiectasis was COPD in 28 cases (41.2%) with a light-moderate pulmonary involvement and Pseudomonas aeruginosa (P. aeruginosa) colonization (70.6%). Seven patients (10.3%) had MNT infection, six of whom had Mycobacterium avium complex (7.35%). Four patients (57.14%) were treated. In the infected patients, P. aeruginosa and the use of inhaled steroids were observed with less frequency. There were no significant differences between the infected and non-infected patients in relation to spirometric values. CONCLUSIONS: The non-cystic fibrosis bronchiectasis could be considered a risk factor for non-tuberculous mycobacterial infection.