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Thorax 57:178-182 doi:10.1136/thorax.57.2.178
  • Occasional review

Eosinophilic bronchitis: clinical manifestations and implications for treatment

  1. P G Gibson1,
  2. M Fujimura2,
  3. A Niimi3
  1. 1Department of Respiratory and Sleep Medicine, John Hunter Hospital, NSW 2310, Australia
  2. 2The Third Department of Internal Medicine, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
  3. 3Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan
  1. Correspondence to:
    Dr P G Gibson, Department of Respiratory and Sleep Medicine, John Hunter Hospital, Locked Bag 1, Hunter Region Mail Centre, NSW 2310 Australia;
    mdpgg{at}mail.newcastle.edu.au
  • Accepted 5 October 2001
  • Revised 4 October 2001

Abstract

Airway inflammation with eosinophils is now reported to occur not only in asthma but in other airway diseases such as cough variant asthma, chronic cough, atopic cough, episodic symptoms without asthma, allergic rhinitis, and COPD. Although the prevalence of eosinophilic bronchitis (EB) is less than in asthma, the causes, mechanisms and treatment of EB in these conditions appears to be similar to asthma where allergen induced IL-5 secretion and symptoms are readily responsive to inhaled corticosteroids. The prognosis of EB without asthma is not known but it may be a precursor for asthma and, if so, recognition of this syndrome may permit effective treatment and reduction in the rising prevalence of asthma. Induced sputum analysis allows recognition of EB in clinical practice. The place of the asthma treatment paradigm with early and sustained corticosteroid treatment needs to be defined in EB without asthma. Airway wall remodelling can occur in rhinitis, COPD, and cough variant asthma with EB. The mechanisms and long term implications of this complication in EB without asthma need to be clarified.

Footnotes