Author/Authors :
Xu, Benyong Tongji University School of Medicine, Shanghai, China , Mao, Yanhua Department of Respiratory Medicine - Shanghai Pulmonary Hospital -Tongji University School of Medicine, Shanghai, China , Wan, Xiaoyu Department of Respiratory Medicine - Shanghai Pulmonary Hospital -Tongji University School of Medicine, Shanghai, China , Chen, Jianhui Tongji University School of Medicine, Shanghai, China , Ye, Meiping Department of Respiratory Medicine - Shanghai Pulmonary Hospital -Tongji University School of Medicine, Shanghai, China , Zhan, Mengling Tongji University School of Medicine, Shanghai, China , Xu, Liyun Department of Respiratory Medicine - Shanghai Pulmonary Hospital -Tongji University School of Medicine, Shanghai, China , Zhao, Lan Department of Respiratory Medicine - Shanghai Pulmonary Hospital -Tongji University School of Medicine, Shanghai, China , Li, Bing Department of Respiratory Medicine - Shanghai Pulmonary Hospital -Tongji University School of Medicine, Shanghai, China , Zhang, Zhemin Department of Respiratory Medicine - Shanghai Pulmonary Hospital -Tongji University School of Medicine, Shanghai, China , Liu, Yang Institute of Antibiotics - Huashan Hospital - Fudan University, Shanghai, China , Chu, Haiqing Department of Respiratory Medicine - Shanghai Pulmonary Hospital -Tongji University School of Medicine, Shanghai, China
Abstract :
Background. Factors determining the prognosis of diffuse panbronchiolitis (DPB) remain unclear at present. 1e objective of this
study was to identify the prognostic value of concomitant bronchiectasis in the macrolide treatment efficacy and exacerbation risk
in DPB patients. Methods. Data of patients initially diagnosed with DPB at the Shanghai Pulmonary Hospital between January
2007 and December 2017 were retrospectively collected and analyzed. 1e patients were divided into two groups according to the
existence of bronchiectasis. Clinical manifestations, laboratory findings, microbiological culture results, as well as exacerbation
risks and treatment outcomes, were compared between these two groups. 1e survival curve and Cox regression analysis models
were additionally constructed to further demonstrate the predicting role of bronchiectasis in DPB exacerbation. Results. Baseline
data revealed more respiratory symptoms, lower body mass index (BMI), and forced expiratory volume in one second (FEV1) as
well as increased isolates of Pseudomonas aeruginosa (P. aeruginosa) in DPB subjects with bronchiectasis than those without.
Furthermore, bronchiectasis was associated with a lower rate of responsiveness to macrolides and increased exacerbation
frequency during follow-up. 1e survival curve and Cox regression analysis showed that comorbid bronchiectasis was linked to
increased time to episode relapse, which remained significant even after controlling for BMI, FEV1, and P. aeruginosa culture
results. Conclusion. 1e coexistence of bronchiectasis predicted a poor outcome of maintenance macrolide therapy and an
increased exacerbation risk in DPB subjects, possibly through its impacts on nutritional status, pulmonary function, and P.
aeruginosa infections.
