Gender aspects of natural course of asthma

Volatility of certain bronchial asthma (BA) phenotype markers is not enough investigated during maturation of pediatric patients. Material and methods. One hundred thirty-one patients with non-severe BA were included; by the age on inclusion date subgroups of “Children” (62 patients aged 6 to 11 years) and “Adolescents” (69 patients aged 12–17 years) were allocated. Every 6 months patients were examined, fulfi d asthma control questionnaires, performed spirometry with salbutamol test, provided hematology results with absolute eosinophil count and height and weight data. Exacerbation and hospitalization numbers, BA severity and controller treatment step were considered. Acquired data were archived; patients’ management was driven by real clinical practice algorithms.Results. Ninety-three patients included (71%) completed at least decade observation. Adolescents and young adults had body mass index higher than 90th percentile by age more often than younger children; some patients had normalized their body mass during observation. BMI and ACT results had moderate reverse correlation (r=–0.64). Eosinophil counts more than 300 cells per microliter conserved longer in older patients: duration median and [Q1; Q3] for “Adolescents” were 11,7 [9,6; 15,3] months and 9.3 [4.8; 11.1] months for “Children” subgroup, difference was significant (р=0.043). Most lung functional parameters were in age normal range. Rare cases of functional obstruction were not stable and did not differ in duration between “Children” 7.3 [6.2; 8.8] months and “Adolescents” 8.4 [6.5; 10.4] months.Conclusion. Phenotype markers of future BA exacerbation risk are quite volatile in pediatric patients and young adults. We recommend repeated evaluation of such markers every 12–18 month of observation to decide on asthma controller change. Simultaneous detection of several markers was quite often but did not lead to more severe asthma course in most patients. Longer duration of elevated BMI or peripheral blood eosinophils were typical for patients with more often BA exacerbations.

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Natural history of phenotype markers in patients with bronchial asthma (a decade’s observation)

Kamaev

Mizernitsky

Шапорова

2023

Ross. vestn. perinatol. pediatr.

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Dependence of thymic stromal lymphopoietin serum concentration from bronchial asthma control level and lung function results in patients of different age groups

et al. 2022

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Introduction. Bronchial asthma (BA) pathogenesis is settled by bronchial wall inflammation, which is the main treatment target.Aim. To study the dependence of thymic stromal lymphopoietin (TSLP) concentration in serum and nasal brush-biopsies from age, spirometry data deterioration and blood eosinophils in patients with uncontrolled BA.Materials and methods. Patients with uncontrolled BA of three age groups: children (6–11 y.o., n = 38), adolescents (14–17 y.o., n = 35) and adults (25–50 y.o., n = 31) were included in 1-year long open prospective study. Clinical history, АСТ/сАСТ questionnaires, lung function test (LFT), common blood count, serum and nasal material to evaluate TSLP were obtained during first visit, if there were no any signs of acute respiratory infection for not less than 14 days. Maintenance therapy was revised based on firstvisit findings. Patient were consequently examined twice with 6 months intervals, examination data, LFT readings, ACT results and eosinophil counts were collected. Statistical analyses included ANOVA (Kruskal-Wallis test) and Pearson’s correlation (r). Differences accepted significant with р < 0,05.Results. Serum TSLP levels did not differ between age groups. TSLP concentration correlate directly and significantly with duration of uncontrolled BA in previous 12 months (r = 0.74). In patients with atopic BA, maximum TSLP level was in dust mites sensitized group (792.6 ± 114.1 pg/ml). We have found greater serum TSLP concentration in patients who demonstrated FEV1 below normal even on optimal controller therapy at Visit 3. Eosinophil count randomly changed inside normal values and did not correlate with asthma control or TSLP level.Conclusion. Prognosis of future asthma exacerbations and LFT decrease is less favourable in patients with high serum TSLP level.

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Gender aspects of natural course of asthma

Cited by 2 publications

References 33 publications

Natural history of phenotype markers in patients with bronchial asthma (a decade’s observation)

Natural history of phenotype markers in patients with bronchial asthma (a decade’s observation)

Dependence of thymic stromal lymphopoietin serum concentration from bronchial asthma control level and lung function results in patients of different age groups

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