- Title
- Age-Related Clinical Characteristics, Inflammatory Features, Phenotypes, and Treatment Response in Asthma
- Creator
- Wang, Ji; Zhang, Xin; McDonald, Vanessa M.; Chen-Yu Hsu, Alan; Liu, Dan; Li, Wei Min; Birring, Surinder S.; Wang, Gang; Zhang, Li; Liu, Ying; Zhang, Hong Ping; Wang, Lei; Kang, De Ying; Oliver, Brian G.; Wan, Hua Jing
- Relation
- Journal of Allergy and Clinical Immunology: In Practice Vol. 11, Issue 1, p. 210-219.e3
- Publisher Link
- http://dx.doi.org/10.1016/j.jaip.2022.09.029
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2023
- Description
- Background: Emerging evidence suggests that aging affects asthma outcomes, but the mechanism remains largely unexplored. Objective: To explore age-related clinical characteristics, inflammatory features, phenotypes, and treatment response in asthma. Methods: This was a prospective cohort study of asthmatic patients with a 12-month follow-up in a real-world setting. Clinical inflammatory and phenotypic characteristics, future risk for exacerbations, and treatment response were assessed across different age groups (young was defined as age 18 to 39 years; middle-aged, 40 to 64 years; and elderly, 65 years or older). Results: Compared with young (n = 106) and middle-aged (n = 179) asthmatic patients, elderly patients (n = 55) had worse airway obstruction, more comorbidities including chronic obstructive pulmonary disease and diabetes, less atopy, and lower levels of IgE and FeNO, and were more likely to have late-onset and fixed airflow obstruction asthma and a reduced risk for having type 2 profile asthma. Levels of IFN-gamma, IL-17A, and IL-8 in induced sputum were significantly increased in elderly asthmatic patients (all P < .05). Path analysis indicated that age directly and significantly led to future exacerbations in asthma, partially mediated by an upregulation of airway IFN-gamma. Moreover, elderly patients with asthma had a reduced treatment response (improvement in FEV1 of 12% or greater, or 200 mL, and a reduction in Borg scores of 1 or greater) (adjusted odds ratio = 0.11; 95% CI, 0.02-0.52; and adjusted odds ratio = 0.12; 95% CI, 0.03-0.49, respectively). Conclusions: This study confirms that asthma in the elderly population represents a specific phenotype and indicates that aging can influence asthma in terms of clinical characteristics, inflammatory features, exacerbations, and treatment response.
- Subject
- asthma; aging; airway inflammation; phenotype; treatment response; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1480826
- Identifier
- uon:50571
- Identifier
- ISSN:2213-2198
- Language
- eng
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