Baseline Features of the Severe Asthma Research Program (SARP III) Cohort: Differences with Age

Teague, W. Gerald; Phillips, Brenda R.; Fahy, John V.; Wenzel, Sally E.; Fitzpatrick, Anne M.; Moore, Wendy C.; Hastie, Annette T.; Bleecker, Eugene R.; Meyers, Deborah A.; Peters, Stephen P.; Castro, Mario; Coverstone, Andrea M.; Bacharier, Leonard B.; Ly, Ngoc P.; Peters, Michael C.; Denlinger, Loren C.; Ramratnam, Sima; Sorkness, Ronald L.; Gaston, Benjamin; Erzurum, Serpil C.; Comhair, Suzy; Myers, Ross; Zein, Joe; DeBoer, Mark D.; Irani, Anne Marie; Israel, Elliot; Levy, Bruce D.; Cardet, Juan Carlos; Phipatanakul, Wanda; Gaffin, Jonathan M.; Holguín, Fernando; Fajt, Merritt L.; Aujla, Shean; Mauger, David T.; Jarjour, Nizar N.

doi:10.1016/j.jaip.2017.05.032

Cited by 238 publications

(182 citation statements)

References 37 publications

(44 reference statements)

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“…Exclusion criteria for SARP [37], including both major comorbidities and smoking Endocrinopathy such as diabetes or PCOS (polycystic ovarian syndrom)…”

Section: Resultsmentioning

confidence: 99%

“…All subjects who made inquiry regarding the study were screened and, if they met the criteria, were enrolled, with one exception: one woman declined to participate for family reasons. Inclusion and exclusion criteria were identical to those in the SARP for non-severe asthma, as we have published [37], except as noted in Table 1. Because of the slow turnaround in DHEAS levels, we treated all eligible women, but our target was women with low baseline DHEAS levels.…”

Section: Subjects and Approvalmentioning

confidence: 99%

“…Those who were not pregnant and were not experiencing asthma exacerbation proceeded with the study. Baseline spirometry, maximum bronchodilator testing, and phlebotomy were performed at the initial visit and 2 weeks later, after the completion of DHEA treatment, according to SARP protocols [7,37]. Three milliliters of blood were drawn and sent to measure baseline DHEAS and other sex steroid levels (all assays required a total of 400 lL serum in the SARP).…”

Section: Protocolmentioning

confidence: 99%

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Dehydroepiandrosterone Supplementation May Benefit Women with Asthma Who Have Low Androgen Levels: A Pilot Study

et al. 2019

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Introduction: Among individuals with severe asthma, FEV 1 is low in individuals with low dehydroepiandrosterone (DHEA) sulfate (DHEAS) levels. In the Severe Asthma Research Program (SARP), no women with DHEAS [ 200 lg/dL had an FEV 1 \ 60% predicted. DHEA has benefited patients with COPD and pulmonary hypertension in small trials. Therefore, we hypothesized that DHEA supplementation may improve FEV 1 in asthmatic women with low DHEAS. Methods: Premenopausal, nonsmoking, otherwise healthy women, 18-50 years old, with mild or moderate asthma and baseline FEV 1 [ 60% predicted received 100 mg DHEA orally every 12 h for 2 weeks. Spirometry and DHEAS were measured at the initial visit and 2 weeks later, after completion of DHEA treatment. Based on our previous work, the primary outcome variable for this pilot study was post-albuterol spirometry in the low-DHEAS group. Subjects also continued their other routine asthma management. Results: Serum DHEAS increased with DHEA treatment in women with starting DHEAS \ 200 lg/dL: this increase was from 71 ± 23 to 725 ± 295 lg/dL (n = 10; p = 0.0001). The increase in the high-DHEAS group was smaller. Post-albuterol FEV 1 increased by 51 mL, from 3.026 ± 0.5 to 3.077 ± 0.49 L (n = 10; p = 0.034 by paired t test, significant after Bonferroni), in women with low DHEAS. In the high-DHEAS group (baseline DHEAS C 200 lg/dl), post-albuterol FEV 1 did not change significantly (n = 3, p = NS). Three subjects were excluded: one had comorbid COPD, one could not perform spirometry, and one did not take the DHEA. There were no adverse effects of DHEA treatment in this trial. Conclusions: Endocrine treatments (corticosteroids) are a mainstay of anti-inflammatory management for moderate and severe asthma. Their use has improved asthma outcomes. Androgens also reduce airway inflammation and promote airway smooth muscle relaxation, but are rarely used clinically for asthma treatment. Our results suggest that the over-thecounter steroid DHEA may improve lung function in asthma outcomes among women with DHEAS \ 200 ug/dL. Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.9939215. Key Summary PointsEndocrine treatments (corticosteroids) are a mainstay of anti-inflammatory management for moderate and severe asthma.Their use has improved asthma outcomes.Androgens also reduce airway inflammation and promote airway smooth muscle relaxation, but are rarely used clinically.Our results suggest that the over-thecounter steroid DHEA may also improve lung function in asthma outcomes among women with DHEAS \ 200 ug/dL.

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“…Exclusion criteria for SARP [37], including both major comorbidities and smoking Endocrinopathy such as diabetes or PCOS (polycystic ovarian syndrom)…”

Section: Resultsmentioning

confidence: 99%

Section: Subjects and Approvalmentioning

confidence: 99%

Section: Protocolmentioning

confidence: 99%

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Dehydroepiandrosterone Supplementation May Benefit Women with Asthma Who Have Low Androgen Levels: A Pilot Study

et al. 2019

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“…Although it is difficult to exactly model distinctions between early-and late-onset disease in humans to validate the findings from experimental models, it should be noted that many patients present with their first symptoms of allergy or asthma in adult life. Indeed, relative to children, adult-onset asthma represents a distinct phenotype, characterized by increased obesity, greater airflow limitation, and less allergen sensitization; thus, it has been proposed that mechanisms besides type 2 inflammatory pathways might inform the severe asthma phenotype observed with advancing age [39]. Moreover, both shared and distinct genetic risk factors have also been identified for childhood-and adult-onset asthma, suggesting some common, but also some different susceptibility profiles at different ages in humans [40].…”

Section: Trends In Immunologymentioning

confidence: 99%

Opening the Window of Immune Opportunity: Treating Childhood Asthma

Lloyd

Saglani

2019

Trends in Immunology

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“…In the large SARP cohort study, CRSwNP were significantly associated with exacerbation frequency [46]. Subsequently, CRS symptom severity has been associated with asthma-related oral corticosteroid use [47].…”

Section: Clinical and Therapeutic Managementmentioning

confidence: 99%

Rhinosinutis and Asthma in Children

et al. 2018

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Rhinosinusitis and asthma are two comorbid conditions that lead to pathological and clinical diseases affecting the respiratory tract. They are connected by significant anatomical, epidemiological, pathophysiological, and clinical evidence, and also share therapeutic principles. The aim of this review is to provide an updated overview of the existing link between rhinosinusitis and asthma focusing on the pediatric age.

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Baseline Features of the Severe Asthma Research Program (SARP III) Cohort: Differences with Age

Cited by 238 publications

References 37 publications

Dehydroepiandrosterone Supplementation May Benefit Women with Asthma Who Have Low Androgen Levels: A Pilot Study

Dehydroepiandrosterone Supplementation May Benefit Women with Asthma Who Have Low Androgen Levels: A Pilot Study

Opening the Window of Immune Opportunity: Treating Childhood Asthma

Rhinosinutis and Asthma in Children

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