Assuntos
Corticosteroides/uso terapêutico , Antiasmáticos/uso terapêutico , Asma/genética , Variação Genética , Fator A de Crescimento do Endotélio Vascular/genética , Administração por Inalação , Adulto , Asma/tratamento farmacológico , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/fisiologiaRESUMO
Inhaled corticosteroids (ICS) are one of the most commonly used asthma therapies and have highly variable treatment success. Polymorphisms in TBX21, a gene important for the biological action of corticosteroids, could be associated with treatment response in asthmatics. We genotyped for rs9910408 in TBX21 in 208 adult asthmatic patients, treated at least 3 years with ICS. Polymorphism rs9910408 was associated with response to ICS treatment. When treatment success was assessed by a decrease in bronchial hyperresponsiveness (BHR), the frequency of AA genotype was significantly higher in good responders (P = 0.049). This genotype related response was even more evident in the subgroups of non-smokers (P = 0.008) and in non-atopic patients (P = 0.009). AA genotype was overrepresented among good responders according to changes in FEV1 in the subgroups of non-smokers (P = 0.013) and in non-atopic patients (P = 0.048). Our results showed that treatment response to ICS, assessed as changes in BHR and FEV1, is associated with TBX21.
Assuntos
Corticosteroides/administração & dosagem , Asma/genética , Polimorfismo Genético/genética , Qualidade de Vida , Fumar , Proteínas com Domínio T/genética , Administração por Inalação , Adulto , Asma/tratamento farmacológico , Estudos de Casos e Controles , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do TratamentoRESUMO
INTRODUCTION: The coexistence of allergic bronchopulmonary aspergillosis and aspergilloma is rare. CASE PRESENTATION: We present the case of a 56-year-old Caucasian man who worked as a farmer, with infiltrates in the right lower and middle lung lobes, partial consolidation of the middle lobe and with previous diagnosis of chronic obstructive bronchitis. Evaluation of our patient led to the diagnosis of allergic bronchopulmonary aspergillosis with coexistent aspergilloma in the right lower lobe. He was treated with oral methylprednisolone and itraconazole. At the five-year follow-up he is without any sign of recurrence. CONCLUSION: Aspergillus infection after the inhalation of spores in the form of a hypersensitivity reaction and saprophytic colonization can be coexistent.