Relationship between airway neutrophilia and ageing in asthmatics and non‐asthmatics

Brooks, Collin; Gibson, Peter G.; Douwes, Jeroen; Dalen, Christine J. van; Simpson, Jodie L.

doi:10.1111/resp.12079

Cited by 50 publications

(49 citation statements)

References 43 publications

(55 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have described the presence of elevated sputum neutrophils in older asthmatics, but did not investigate the relationship between elevated sputum neutrophils and clinical outcomes measures in this population [5,25]. Our results demonstrate for the first time that sputum neutrophilia is associated with poorly controlled asthma, based on the validated ACQ, in asthmatics ages 65 years and older.…”

Section: Discussioncontrasting

confidence: 47%

“…Despite high morbidity and mortality from asthma, few studies have examined airway inflammatory patterns in asthmatics ages 65 years and older [2,5,25]. Moreover, no studies have previously examined the relationship between traffic pollution and airway inflammation in this population, despite their increased susceptibility to air pollutants [8,10,12,13].…”

Section: Discussionmentioning

confidence: 99%

“…those generated during idling versus moving traffic situations) may lead to variable inflammatory responses [33]. It is also possible that traffic pollution exposure may result in differential immune responses based on age-related differences in the inflammatory milieu [5,24,25]. Further evaluation of these relationships with a larger sample size, repeated sputum sampling over time, and additional biomarkers of eosinophilic and neutrophilic inflammation may provide much needed insights regarding these issues.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Chronic traffic pollution exposure is associated with eosinophilic, but not neutrophilic inflammation in older adult asthmatics

et al. 2013

View full text Add to dashboard Cite

Objective Airway inflammatory patterns in older asthmatics are poorly understood despite high asthma-related morbidity and mortality. In this study, we sought to define the relationship between exposure to traffic pollutants, biomarkers in induced sputum, and asthma control in older adults. Methods Induced sputum was collected from 35 non-smoking adults ≥65 years with a physician’s diagnosis of asthma and reversibility with a bronchodilator or a positive methacholine challenge. Patients completed the Asthma Control Questionnaire (ACQ), and Elemental Carbon Attributable to Traffic (ECAT), a surrogate for chronic diesel particulate exposure, was determined. Equal numbers of subjects with high (≥0.39 µg/m3) versus low (<0.39 µg/m3) ECAT were included. Differential cell counts were performed on induced sputum, and myeloperoxidase (MPO) and eosinophil peroxidase (EPO) were measured in supernatants. Regression analyses were used to evaluate the relationship between sputum findings, ACQ scores, and ECAT. Results After adjustment for potential confounders, subjects with poorly controlled asthma based on ACQ ≥ 1.5 (n = 7) had significantly higher sputum eosinophils (median = 4.4%) than those with ACQ < 1.5 (n = 28; eosinophils = 2.6%; β = 10.1 [95% CI = 0.1–21.0]; p = 0.05). Subjects with ACQ ≥ 1.5 also had significantly higher sputum neutrophils (84.2% versus 65.2%; β = 7.1 [0.2–14.6]; p = 0.05). Poorly controlled asthma was associated with higher sputum EPO (β = 2.4 [0.2–4.5], p = 0.04), but not MPO (p = 0.9). High ECAT was associated with higher eosinophils (β = 10.1 [1.8–18.4], p = 0.02) but not higher neutrophils (p = 0.6). Conclusions Poorly controlled asthma in older adults is associated with eosinophilic and neutrophilic inflammation. Chronic residential traffic pollution exposure may be associated with eosinophilic, but not neutrophilic inflammation in older asthmatics.

show abstract

Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Chronic traffic pollution exposure is associated with eosinophilic, but not neutrophilic inflammation in older adult asthmatics

et al. 2013

View full text Add to dashboard Cite

show abstract

“…165,181 Misclassification of inflammatory phenotypes may easily occur due to confounding factors, such as concurrent corticosteroid use, smoking, age, air pollution, occupation, high-grade exercise, respiratory infection, sensitization to Aspergillus, and gastroesophageal disease. 165,[182][183][184][185][186][187] One study showed that a pure neutrophilic asthma phenotype could not be identified after withdrawal of inhaled corticosteroids for nonsmoking adults with moderately severe stable asthma. 165 Reinstitution of inhaled corticosteroid treatment with these subjects was associated with increased airway neutrophils and a switch to a neutrophilic phenotype.…”

Section: Neutrophilic Asthmamentioning

confidence: 98%

Developing and Emerging Clinical Asthma Phenotypes

Hekking

Bel

2014

The Journal of Allergy and Clinical Immunology: In Practice

View full text Add to dashboard Cite

“…In the elderly, asthma is more neutrophilic than in younger asthmatic patients, whatever the severity of asthma [20, 23]. This may be related to aging itself, to respiratory infections, corticosteroid intake or other factors.…”

Section: Introductionmentioning

confidence: 99%

Asthma in the elderly patient

Boulet

2016

asthma res and pract

View full text Add to dashboard Cite

Asthma affects a significant proportion of elderly patients, but unfortunately, it is responsible for a high asthma-related morbidity and mortality in this population. This may be related not only to the development of a more severe asthma phenotype compared to younger patients, with more marked airway obstruction and a more neutrophilic type of airway inflammation, but also to the presence of many co-morbid conditions. Furthermore, in older patients, asthma is often under-diagnosed, undertreated and poorly managed. Unfortunately, elderly patients have usually been excluded of clinical trials on asthma and there is an urgent need to perform more research on the optimal management of asthma in this population.

show abstract

Relationship between airway neutrophilia and ageing in asthmatics and non‐asthmatics

Abstract: Airway neutrophilia is related to age in adults, with a neutrophilic asthma phenotype present in older adults. The use of appropriate age-specific reference values is recommended for future studies aimed at elucidating the role of neutrophils in asthma.

Cited by 50 publications

References 43 publications

Chronic traffic pollution exposure is associated with eosinophilic, but not neutrophilic inflammation in older adult asthmatics

Chronic traffic pollution exposure is associated with eosinophilic, but not neutrophilic inflammation in older adult asthmatics

Developing and Emerging Clinical Asthma Phenotypes

Asthma in the elderly patient

Contact Info

Product

Resources

About