Differences in the Clinical Characteristics of Early- and Late-Onset Asthma in Elderly Patients

Abstract

<?tex id="Q1" staff-cmt="It is very important for the corresponding author to have a linked ORCID (Open Researcher and Contributor ID) account on MTS. To register a linked ORCID account, please go to the Account Update page (http://mts.hindawi.com/update/Differences between early-onset and late-onset asthma in elderly subjects have not been comprehensively described in China. We conducted a cross-sectional study to determine the phenotypic differences between early-onset asthma (EOA) and late-onset asthma (LOA) in elderly patients. We collected clinical and physiological data from 176 elderly patients with asthma. Participants were divided into two groups: EOA group and LOA group. Demographics, comorbidities, inflammatory parameters, lung function, severity, asthma control, and medication use among EOA and LOA elderly patients were compared. Elderly subjects with EOA had more atopic disease, a stronger positive family history of asthma, higher IgE, and exhaled nitric oxide levels as compared to those with LOA. In contrast, elderly subjects with LOA had lower lung function and more marked fixed airflow obstruction (FAO). Elderly subjects with LOA had a higher incidence of chronic obstructive pulmonary disease (COPD). No differences were observed in age, gender, BMI, history of smoking, severity, and asthma control between the two groups. Both similarities and differences exist between elderly subjects with EOA and those with LOA in China. Further work is required to determine the pathophysiological, clinical, and therapeutic implications for different asthma phenotypes in elderly subjects.

Winds of change a tale of: asthma and microbiome

“…Furthermore, the gut and airway microbiota in the first year of life has been reported to induce T-reg cells that enhance tolerogenic immunity in infants at high risk for asthma ( Busse and Rosenwasser, 2003 ). Multiple investigations have shown differences between the lung and gut microbiome of individuals with established asthma vs. healthy subjects, being the population with asthma the ones with lower bacterial diversity ( Marsland et al, 2015 ; Carr et al, 2019 ; Liu et al, 2020 ). Case–control studies have associated gut dysbiosis with a reduction in the specific genera Faecalibacterium, Bifidobacterium, Lachnospira, Veillonella , and Rothia ( Yap et al, 2014 ; Arrieta et al, 2015 ).…”

“…Asthma is a heterogeneous phenotypic disease that has not been fully characterized in the elderly ( Liu et al, 2020 ). However, it is known that reversible obstruction, hyperresponsiveness, and chronic airway inflammation are representative features of this disease.…”

Comparações de aspectos clínicos, funcionais pulmonares, inflamatórios e de prevalência de atopia entre idosos com asma de início tardio e asma de longa duração

“…Note-se que erros de técnica de uso de dispositivos não ocorrem apenas entre os idosos ou em países em desenvolvimento, como mostram vários estudos ( VAN BEERENDONK et al, 1998;WESTERIK et al, 2016;MELANI et al, 2011;MOLIMARD et al, 2017;USMANI et al, 2018) Em suma, no que diz respeito a nossa amostra total, encontramos proporção razoável de pacientes com bom controle, embora a grande maioria usasse dispositivos de forma incorreta e a adesão fosse aquém da adequada. Vários estudos já mostraram que o uso incorreto de dispositivos pode gerar agravos de saúde em asma e DPOC em diferentes contextos (MELANI et al, 2011;WESTERIK et al, 2016;AL-JADAHLI et al, 2013;KOCKS et al, 2018) KAEMMERLEN;DAVIS, 1991;CASSINO et al, 2000;HERSCHER et al, 2017;LIU et al, 2020). Em um estudo com critérios de inclusão semelhantes aos nossos, Herscher et al (2017) Isso é relevante pois as tentativas de se estabelecerem critérios diagnósticos de sobreposição asma-DPOC até o momento estão em aprimoramento (SIN et al, 2016;BONTEN et al, 2017;WOODRUFF et al, 2017).…”