PMID- 36012941 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220830 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 11 IP - 16 DP - 2022 Aug 11 TI - Can Leukotriene Receptor Antagonist Therapy Improve the Control of Patients with Severe Asthma on Biological Therapy and Coexisting Bronchiectasis? A Pilot Study. LID - 10.3390/jcm11164702 [doi] LID - 4702 AB - INTRODUCTION: Asthma and bronchiectasis appear to be two related diseases and in their complex inflammatory interaction, the cysteinyl leukotriene/cysteinyl leukotriene receptor 1 (cysLT/cysLTR1) axis appears to play an important role given its involvement also in the neutrophilic pathway. To our knowledge, few studies have been conducted so far to evaluate the role of the leukotriene cysLT/cysLTr1 axis in the management of clinical and inflammatory outcomes within a population of patients with severe asthma and bronchiectasis. The aim of our study was to verify in this population the effect of leukotriene receptor antagonist (LTRA) therapy in clinical and inflammatory control before and after 6 months of introduction of biologic therapy. METHODS: We retrospectively enrolled, from eight different severe asthma centers' outpatients, 36 atopic patients with the simultaneous presence of non-cystic fibrosis (non-CF) and non-allergic bronchopulmonary aspergillosis (non-ABPA) bronchiectasis and severe asthma. The first biological injection was performed at baseline (T0 time). Patients who were already taking LTRA therapy at time T0 were recorded, and no new prescriptions were made. We observed our population over a 6-month period (T1 time). At the baseline we collected the following data: baseline characteristics, clinical history, high resolution computed tomography and bronchiectasis-related parameters and skin prick test. At both times T0 and T1 we collected the following data: asthma control test (ACT), asthma control questionnaire (ACQ), immunoglobulin E (IgE) level, blood count, fractional exhaled nitric oxide 50 (FeNO 50) and flow-volume spirometry. The study was retrospectively registered. RESULTS: Our population had a mean age of 59.08 +/- 11.09 and 50% were female. At T1, patients on LTRA therapy had a significantly lower FeNO value (33.03 +/- 23.61 vs. 88.92 +/- 77.96; p = 0.012). We assessed that the value of DeltaFeNO (FeNO 50 T1 - FeNO 50 T0) and the number of unplanned specialist visits allowed a discrimination of 66.7% in the presence of LTRA therapy. We also verified how low FeNO values at time T1 were statistically significant predictors of LTRA therapy (ODD = 9.96 (0.94-0.99); p = 0.032). CONCLUSION: The presence of LTRA in therapy in a population of severe asthmatics with coexisting non-ASBPA bronchiectasis and non-cystic fibrosis, acting simultaneously on the T helper type 2 (TH2) pathway and probably on the neutrophilic component of bronchiectasis, would allow a further amplification of the beneficial effects of biological therapy, leading to a reduction in the number of unplanned visits to specialists. FAU - Quaranta, Vitaliano Nicola AU - Quaranta VN AD - Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University "Aldo Moro" of Bari, 70121 Bari, Italy. FAU - Dragonieri, Silvano AU - Dragonieri S AD - Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University "Aldo Moro" of Bari, 70121 Bari, Italy. FAU - Crimi, Nunzio AU - Crimi N AD - Department of Internal Medicine and Specialistic Medicine, Section of Respiratory Diseases, University of Catania, 95123 Catania, Italy. FAU - Crimi, Claudia AU - Crimi C AUID- ORCID: 0000-0002-9088-5214 AD - Department of Internal Medicine and Specialistic Medicine, Section of Respiratory Diseases, University of Catania, 95123 Catania, Italy. FAU - Santus, Pierachille AU - Santus P AUID- ORCID: 0000-0003-3462-8253 AD - Department of Clinical and Biomedical Sciences, Division of Respiratory Diseases, Universita degli Studi di Milano, "L. Sacco" University Hospital, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy. FAU - Menzella, Francesco AU - Menzella F AUID- ORCID: 0000-0003-3950-5789 AD - Pulmonology Unit, S. Valentino Hospital, 31044 Montebelluna City, Italy. FAU - Pelaia, Corrado AU - Pelaia C AUID- ORCID: 0000-0002-4236-7367 AD - Department of Health Sciences, Section of Respiratory Disease, University ''Magna Graecia'' of Catanzaro, 88100 Catanzaro, Italy. FAU - Scioscia, Giulia AU - Scioscia G AUID- ORCID: 0000-0002-2667-077X AD - Department of Medical and Surgical Sciences, University Hospital Policlinico Riuniti of Foggia, 71122 Foggia, Italy. FAU - Caruso, Cristiano AU - Caruso C AUID- ORCID: 0000-0001-7631-029X AD - UOSD DH Gastroenterology Polyclinic Foundation A. Gemelli IRCCS, Department of Medical and Surgical Sciences, Cattolica University del Sacro Cuore, 00168 Rome, Italy. FAU - Bargagli, Elena AU - Bargagli E AUID- ORCID: 0000-0002-8351-3703 AD - Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, 53100 Siena, Italy. FAU - Kostikas, Konstantinos AU - Kostikas K AUID- ORCID: 0000-0003-0774-3942 AD - Respiratory Medicine Department, University of Ioannina School of Medicine, 45500 Ioannina, Greece. FAU - Kyriakopoulos, Christos AU - Kyriakopoulos C AUID- ORCID: 0000-0001-8806-2561 AD - Respiratory Medicine Department, University of Ioannina School of Medicine, 45500 Ioannina, Greece. FAU - Scichilone, Nicola AU - Scichilone N AUID- ORCID: 0000-0001-6400-6573 AD - Promise Department, University of Palermo, 90133 Palermo, Italy. FAU - Carpagnano, Giovanna Elisiana AU - Carpagnano GE AD - Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University "Aldo Moro" of Bari, 70121 Bari, Italy. LA - eng PT - Journal Article DEP - 20220811 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC9410441 OTO - NOTNLM OT - LTRA therapy OT - biological OT - bronchiectasis OT - severe asthma COIS- The authors declare no conflict of interest. EDAT- 2022/08/27 06:00 MHDA- 2022/08/27 06:01 PMCR- 2022/08/11 CRDT- 2022/08/26 01:27 PHST- 2022/07/04 00:00 [received] PHST- 2022/08/03 00:00 [revised] PHST- 2022/08/10 00:00 [accepted] PHST- 2022/08/26 01:27 [entrez] PHST- 2022/08/27 06:00 [pubmed] PHST- 2022/08/27 06:01 [medline] PHST- 2022/08/11 00:00 [pmc-release] AID - jcm11164702 [pii] AID - jcm-11-04702 [pii] AID - 10.3390/jcm11164702 [doi] PST - epublish SO - J Clin Med. 2022 Aug 11;11(16):4702. doi: 10.3390/jcm11164702.