Airway neutrophil inflammatory phenotype in older subjects with asthma

Nyenhuis, Sharmilee M.; Schwantes, Elizabeth A.; Evans, Michael D.; Mathur, Sameer K.

doi:10.1016/j.jaci.2010.02.015

Cited by 59 publications

(64 citation statements)

References 8 publications

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“…In some studies, the neutrophil count in induced sputum was reportedly greater in elderly than in nonelderly subjects with 17,18 and without 49 asthma, despite the existence of conflicting reports. 19 In the present study, there were no differences in induced sputum cell differentials between elderly and nonelderly subjects with asthma, although elderly subjects had marginally increased neutrophils in their sputum and blood compared with nonelderly patients with asthma.…”

Section: Discussionmentioning

confidence: 98%

“…Moreover, aging may affect immunologic and inflammatory profiles in patients with asthma. Airway neutrophilia may be more predominant in elderly patients with asthma than in the nonelderly, 17,18 although conflicting evidence exists showing that sputum cellular profiles are similar in young and elderly patients with asthma. 19 Because comprehensive studies on elderly asthma, addressing its physiologic, radiologic, and immunologic features, are scarce, these pathophysiologic characteristics of elderly asthma were investigated using spirometry, CT, IOS, induced sputum, FeNO, and IgE measurements and compared with results in nonelderly patients with asthma.…”

Section: Introductionmentioning

confidence: 99%

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Pathophysiological characteristics of asthma in the elderly: a comprehensive study

Inoue

Niimi

Takeda

et al. 2014

Annals of Allergy, Asthma & Immunology

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Pathophysiological characteristics of asthma in the elderly: a comprehensive study

Inoue

Niimi

Takeda

et al. 2014

Annals of Allergy, Asthma & Immunology

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“…Asthma in the older adult displays many of the hallmarks of COPD such as onset of symptoms later in life, partial reversibility on pulmonary function testing and association with neutrophilic inflammation (9) . Co-existing COPD with an asthmatic M A N U S C R I P T…”

Section: Clinical Assessmentmentioning

confidence: 99%

Advances in the Diagnosis and Management of Asthma in Older Adults

Al‐Alawi

Hassan

Chotirmall

2014

The American Journal of Medicine

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Global estimates on ageing predict an increased burden of asthma in the older population. Consequently, its recognition, diagnosis and management in clinical practice require optimization. This review aims to provide an update for clinicians highlighting advances in the understanding of the ageing process and immunosenescence together with their applicability to asthma from a diagnostic and therapeutic perspective. Ageing impacts airway responses, immune function and influences efficacy of emerging phenotype-specific therapies when applied to the elderly patient. Differentiating eosinophilic and neutrophilic disease accounts for atopic illness and distinguishes long-standing from late-onset asthma. Therapeutic challenges in drug delivery, treatment adherence and side effect profiles persist in the older patient while novel recording devices developed to aid detection of an adequate inhalation evaluates treatment effectiveness and compliance more accurately than previously attainable. Anti-cytokine therapies improve control of brittle asthma while bronchial thermoplasty is an option in refractory cases. Multi-dimensional intervention strategies prove best in the management of asthma in the older adult which remains a condition that is not rare but rarely diagnosed in this patient population.

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“…In fact, airways remodeling and a possible coexisting COPD can determine a greater asthma severity in the elderly (11). Older patients with asthma have significantly increased percentages of sputum neutrophils (12). This pattern is a characteristic of intrinsic asthma with neutrophilic inflammation that may be associated to a more severe obstructive disease and a poor response to treatment (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%