Non-asthmatic eosinophilic bronchitis

Non-asthmatic eosinophilic bronchitis (NAEB) is a chronic inflammatory disease of the respiratory system. It was first described by Gibson et al. 30 years ago. Main symptoms of NAEB are chronic cough and sputum eosinophilia in patients without bronchial hyperresponsiveness. Induced sputum and/or bronchial lavage (BAL) are the most important diagnostic methods of NAEB. The results of recent studies, suggest that NAEB is a separate disease rather than early stage of asthma. NAEB is often mistakenly diagnosed as a cough variant of asthma, probably because of a good response to inhaled steroids and difficult access to induced sputum examination or BAL. The main treatment of NAEB is inhaled steroid therapy (ICS), in recent years it has been shown that reduced dose of ICS in combination with montelukast, has a comparable antitussive and anti-inflammatory effect. Eosinophilic bronchitis is characterized by periods of relapse and remission, risk factors of exacerbations have not been clearly identified yet. This article discusses etiology, diagnostics (including differential diagnostics), disease course and treatment of NAEB patients. There is a need for further studies, in order to understand the mechanisms of NAEB and to determine diagnostic and therapeutic standards.