Characterization and redox mechanism of asthma in the elderly

Abstract

Asthma is a chronic disease characterized by reversible airflow limitation, coughing, bronchial constriction, and an inflammatory immune response. While asthma has frequently been categorized as emerging in childhood, evidence has begun to reveal that the elderly population is certainly susceptible to late-onset, or even long-standing asthma. Non-atopic asthma, most commonly found in elderly patients is associated with elevated levels of serum and sputum neutrophils and may be more detrimental than atopic asthma. The mortality of asthma is high in the elderly since these patients often possess more severe symptoms than younger populations. The redox mechanisms that mediate inflammatory reactions during asthma have not been thoroughly interpreted in the context of aging. Thus, we review the asthmatic symptoms related to reactive oxygen species (ROS) and reactive nitrogen species (RNS) in seniors. Moreover, immune status in the elderly is weakened in part by immunosenescence, which is broadly defined as the decline in functionality of the immune system that corresponds with increasing age. The effects of immunosenescence on the expression of biomarkers potentially utilized in the clinical diagnosis of asthma remain unclear. It has also been shown that existing asthma treatments are less effective in the elderly. Thus, it is necessary that clinicians approach the diagnosis and treatment of asthmatic senior patients using innovative methods. Asthma in the elderly demands more intentional diagnostic and therapeutic research since it is potentially one of the few causes of mortality and morbidity in the elderly that is largely reversible.

Oxidative stress biomarkers and asthma characteristics in adults of the EGEA study

“…Furthermore, in the literature, as in our analyses, FlOPs were shown to be associated with irritant exposures, such as tobacco smoke ( [18] and online supplementary material) or occupational exposure to irritant chemicals (e.g. cleaning products) [29], which have also been associated with nonallergic asthma phenotypes [37][38][39][40].…”

“…However, we did not observe a significant association between asthma duration and 8-isoprostanes level (data not shown). Another hypothesis is that adult-onset asthma and childhood asthma, which are two different asthma phenotypes [4,37], may have partly distinct biological mechanisms.…”

Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

“…All these features, different in younger subjects, may explain the reduced effect of Omalizumab in the elderly. Actually, the development of late-onset adult asthma may be also the clinical consequence of immunosenescence that would lead to decline in functionality of the immune system with increasing age (35)(36)(37)(38). This age-related process determines a progressive impaired mucociliary clearance, changes in airway neutrophil, eosinophil, and mast cell numbers and function over an altered antigen presentation and decreased specific antibody responses (37).…”

Oxidative stress biomarkers and asthma characteristics in adults of the EGEA study

“…Another hypothesis is that adult-onset asthma and childhood asthma, which are two different asthma phenotypes [4,37], may have partly distinct biological mechanisms.…”

“…Interestingly, a significant and positive association was observed between FlOPs and neutrophilic asthma suggesting that FlOPs may be related to a non-allergic phenotype. Furthermore, in the literature as in our analyses, FlOPs were shown to be associated with irritant exposures, such as tobacco smoke ( [18] and online supplementary data) or occupational exposure to irritant chemicals (e.g., cleaning products) [29], which have also been associated with non-allergic asthma phenotypes [37][38][39][40].…”