Little is known about the prognosis of adults with new-onset asthma. Cross-sectional studies suggest that these patients may exhibit accelerated decline in forced expiratory volume in 1 s (FEV). However, risk factors for accelerated decline in lung function have not yet been identified.We aimed to identify these risk factors in a prospective 5-year follow-up study in 200 adults with newly diagnosed asthma. In the current study, clinical, functional and inflammatory parameters were assessed annually for 5 years. Linear mixed-effects models were used to identify predictors.Evaluable lung function sets of 141 patients were available. Median (interquartile range) change in post-bronchodilator FEV was -17.5 (-54.2 to +22.4) mL per year. Accelerated decline in FEV was defined by the lower quartile of decline (>54.2 mL per year). Nasal polyps, number of blood and sputum eosinophils, body mass index, and level of exhaled nitric oxide were univariably associated with decline in lung function. Only the latter two were independently associated. Using cut-off values to identify patients at highest risk showed accelerated decline in FEV in all patients with combined exhaled nitric oxide fraction () ≥57 ppb and body mass index (BMI) ≤23 kg·mWe conclude that adults with new-onset asthma with both high levels of exhaled nitric oxide and low BMI are at risk of accelerated decline in lung function.

28BACKGROUND: Adult-onset asthma is an important but relatively understudied asthma

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We showed that by using high and low cut-off values, one single measurement of blood eosinophils, but not FeNO in the initial phase of new-onset asthma in adults can be used to predict persistence or absence of blood eosinophilia in asthma.

proteins: an NMR study on Blomia tropicalis major allergen. Structure. 2008;16(1):125-136. 3. Chan SL, Ong TC, Gao YF, et al. Nuclear magnetic resonance structure and IgE epitopes of Blo t 5, a major dust mite allergen. J Immunol. 2008;181(4):2586-2596. 4. Carvalho KA, de Melo-Neto OP, Magalhaes FB, et al. Blomia tropicalis Blo t 5 and Blo t 21 recombinant allergens might confer higher specificity to serodiagnostic assays than whole mite extract. BMC Immunol. 2013;14:11. 5. Himly M, Wallner M, Zaborsky N, et al. Physicochemical characterization of recombinant allergens and hypoallergenic variants. Arb Paul Ehrlich Inst Bundesinstitut Impfstoffe Biomed Arzneim Langen Hess. 2013;97:101-105. 6. Machado Y, Freier R, Scheiblhofer S, et al. Fold stability during endolysosomal acidification is a key factor for allergenicity and immunogenicity of the major birch pollen allergen. J Allergy Clin Immunol. 2016;137(5):1525-1534. 7. Wolf M, Aglas L, Twaroch TE, et al. Endolysosomal protease susceptibility of Amb a 1 as a determinant of allergenicity.

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