Asthma in the elderly and late‐onset adult asthma

Dunn, Ryan; Busse, Paula J.; Wechsler, Michael E.

doi:10.1111/all.13258

Cited by 162 publications

(144 citation statements)

References 151 publications

(161 reference statements)

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“…This finding is supported by a recent study showing that mucus profiles in elderly CRS patients (older 60 years old) were characterized by exaggerated neutrophilic inflammatory responses, which were associated with clinical infection . In addition to upper airway inflammation, the underlying inflammation of elderly asthmatics are different from those of younger patients and are less type 2‐associated . The other feature of age‐related cytokine changes in the ENP group is that smoking history significantly affected the age‐related endotype in ENP, whereas atopy status did not (Figure 2A).…”

Section: Discussionsupporting

confidence: 77%

Age‐associated changes in chronic rhinosinusitis endotypes

Ryu

Dhong²,

Park

et al. 2020

Clin Experimental Allergy

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Background: Immunologic function in innate and adaptive immunity changes with the ageing process. Thus, age-related cytokine profiles in chronic rhinosinusitis (CRS) need to be investigated for precision medicine.Objective: The objective of this study was to characterize age-related changes in immunologic profiles according to CRS subtypes.Methods: Subjects in control (n = 29), CRS without nasal polyps (CRSsNP, n = 86), and CRS with nasal polyps (eosinophilic NP: ENP, n = 81; non-eosinophilic NP: NENP, n = 113) were enrolled in this study. Twenty markers for type 1/2/3 inflammation and other inflammatory processes were measured in homogenates of sinonasal tissues and statistically analysed. Results:In control tissues, type 2/3 and proinflammatory mediators showed an inverse correlation with age. CRSsNP and NENP showed an age-related increase in type 2 cytokines and a decline in type 3 cytokines. Interestingly, the age-related decrease in type 3 mediators was associated with those of CT scores in NENP. ENP showed an age-related increase in type 3 cytokines with type 2 mediators sustained at high levels.Smokers with ENP demonstrated age-associated increases in type 1/2/3 mediators as well as CT scores. These age-related patterns in each CRS were confirmed by statistically adjusting atopy status, smoking history, and disease duration. Conclusion: Age-associated cytokine changes differed among CRS subtypes and control tissues. CRSsNP and NENP demonstrated a decline in type 3 mediators and increase in type 2 mediators, whereas type 3 mediators increased with age in ENP. K E Y W O R D S age, cytokine, endotype, rhinosinusitis S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section.

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Section: Discussionsupporting

confidence: 77%

Age‐associated changes in chronic rhinosinusitis endotypes

Ryu

Dhong²,

Park

et al. 2020

Clin Experimental Allergy

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“…The age subgroups were divided considering the distinct characteristics of asthma in young and adult population . The elderly asthma patients were subgrouped, because they have immunologic changes with aging and higher comorbidities than younger adult population …”

Section: Methodsmentioning

confidence: 99%

Increased risk of psoriasis in children and elderly patients with asthma: a longitudinal follow‐up study using a national sample cohort

Kim

Min

et al. 2019

Int Forum Allergy Rhinol

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Background: Several previous studies reported the elevated risk of asthma in children with psoriasis. This study aimed to extend previous research regarding the risk of psoriasis in children with asthma to an entire population subdivided by age. Methods:The 2002-2013 Korean Health Insurance Review and Assessment Service-National Sample Cohort (HIRA-NSC) was used. The 167,693 participants with asthma were matched with 167,693 control participants for age, sex, income, region of residence, hypertension history, diabetes history, and dyslipidemia history. In both the asthma and control groups, the occurrences of asthma were investigated. The crude and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for psoriasis with respect to asthma status were determined using stratified Cox proportional hazards models. Subgroup analyses were conducted according to age and sex. Results:The prevalence of psoriasis was 0.5% (95% CI, 0.4% to 0.5%; n = 771/167,693) in the asthma group and 0.4% (95% CI, 0.3% to 0.4%; n = 589/167,693) in the con-trol group (p < 0.001). The asthma group (adjusted HR = 1.19; 95% CI, 1.07 to 1.33; p = 0.002) demonstrated higher HRs for psoriasis than did the control group. This result was consistent in the <15 years old, ࣙ60 years old, and women subgroups. Conclusion:Asthma was associated with the elevated risk of psoriasis. The possible risk of psoriasis needs to be considered when managing asthma patients. Future study is warranted for the risk of psoriasis according to the endotypes of asthma. C 2019 ARS-AAOA, LLC.

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“…The aging lung is associated with decreased lung function due to loss of elastic recoil and mechanical disadvantages. In addition to these consequences of normal aging, immunosenescence likely has important consequences in elderly asthmatics [77]. While mechanisms have not been fully elucidated, emerging data suggest that older asthmatics have increased sputum neutrophilia secondary to Th1 and Th17 inflammation [78, 79].…”

Section: Introductionmentioning

confidence: 99%

Understanding Asthma Phenotypes, Endotypes, and Mechanisms of Disease

Kuruvilla

Lee

2018

Clinic Rev Allerg Immunol

828

719

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The model of asthma as a single entity has now been replaced by a much more complex biological network of distinct and interrelating inflammatory pathways. The term asthma is now considered an umbrella diagnosis for several diseases with distinct mechanistic pathways (endotypes) and variable clinical presentations (phenotypes). The precise definition of these endotypes is central to asthma management due to inherent therapeutic and prognostic implications. This review presents the molecular mechanisms behind the heterogeneity of airway inflammation in asthmatic patients. Asthma endotypes may be broadly regarded as type 2 (T2) high or T2-low. Several biologic agents have been approved for T2-high asthma, with numerous other therapeutics that are incipient and similarly targeted at specific molecular mechanisms. Collectively, these advances have shifted existing paradigms in the approach to asthma to tailor novel therapies.

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Asthma in the elderly and late‐onset adult asthma

Cited by 162 publications

References 151 publications

Age‐associated changes in chronic rhinosinusitis endotypes

Age‐associated changes in chronic rhinosinusitis endotypes

Increased risk of psoriasis in children and elderly patients with asthma: a longitudinal follow‐up study using a national sample cohort

Understanding Asthma Phenotypes, Endotypes, and Mechanisms of Disease

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