重症哮喘研究计划（SARP III）队列的基线特征：差异与年龄
2017/09/29
摘要
背景和目的：年龄对哮喘严重程度的影响了解甚少。本研究的目的是比较重症哮喘研究计划（SARP）III队列中重症哮喘和非重症哮喘的基线特征，并在横截面上观察年龄对这些特征的影响。
方法：SARP III是国家卫生研究院/国家心脏肺血液研究所多站点3年队列研究，旨在调查重症哮喘的机制。样本包括188名儿童（111名重度，77名非重度）和526名成年人（313名重度，213名非重度），其特征是根据年龄和严重程度比较人口特征，症状，保健利用，肺功能和炎症标志。
结果:与非重症哮喘儿童相比，重症哮喘儿童症状更多，发作次数多，但体重，支气管扩张剂后肺功能或炎症标志物无差异。儿童期后，随着年龄的增长，队列中妇女比例较高，过敏原敏感性降低，血嗜酸性粒细胞总体减少。与非重症哮喘患者相比，重症哮喘患者年龄较大，肥胖，气道受限明显，血嗜酸性粒细胞较高的中年人入院率最高，但过敏原敏感性较低。
结论：哮喘的表型特征随着严重程度和年龄的增长而不同。随着年龄的增长，重症哮喘患者更加肥胖，气流受限更严重，过敏原敏感性降低，变异2型炎症反应。2型炎症途径之外的新机制可能预示随着年龄增长的重症哮喘表型。
Baseline Features of the Severe Asthma Research Program (SARP III) Cohort: Differences with Age.
Teague WG1, Phillips BR2, Fahy JV3, Wenzel SE4, Fitzpatrick AM5, Moore WC6, Hastie AT6, Bleecker ER6, Meyers DA6, Peters SP6, Castro M7, Coverstone AM7, Bacharier LB7, Ly NP3, Peters MC3, Denlinger LC8, Ramratnam S8, Sorkness RL8, Gaston BM9, Erzurum SC10, Comhair SAA10, Myers RE9, Zein J10, DeBoer MD11, Irani AM12, Israel E13, Levy B13, Cardet JC13, Phipatanakul W13, Gaffin JM13, Holguin F4, Fajt ML4, Aujla SJ4, Mauger DT2, Jarjour NN8.
Abstract
BACKGROUND AND OBJECTIVES:The effect of age on asthma severity is poorly understood. The objective of this study was to compare the baseline features of severe and nonsevere asthma in the Severe Asthma Research Program (SARP) III cohort, and examine in cross section the effects of age on those features.
METHODS:SARP III is a National Institutes of Health/National Heart Lung Blood Institute multisite 3-year cohort study conducted to investigate mechanisms of severe asthma. The sample included 188 children (111 severe, 77 nonsevere) and 526 adults (313 severe, 213 nonsevere) characterized for demographic features, symptoms, health care utilization, lung function, and inflammatory markers compared by age and severity.
RESULTS:Compared with children with nonsevere asthma, children with severe asthma had more symptoms and more historical exacerbations, but no difference in body weight, post-bronchodilator lung function, or inflammatory markers. After childhood, and increasing with age, the cohort had a higher proportion of women, less allergen sensitization, and overall fewer blood eosinophils. Enrollment of participants with severe asthma was highest in middle-aged adults, who were older, more obese, with greater airflow limitation and higher blood eosinophils, but less allergen sensitization than adults with nonsevere asthma.
CONCLUSIONS:The phenotypic features of asthma differ by severity and with advancing age. With advancing age, patients with severe asthma are more obese, have greater airflow limitation, less allergen sensitization, and variable type 2 inflammation. Novel mechanisms besides type 2 inflammatory pathways may inform the severe asthma phenotype with advancing age.
背景和目的：年龄对哮喘严重程度的影响了解甚少。本研究的目的是比较重症哮喘研究计划（SARP）III队列中重症哮喘和非重症哮喘的基线特征，并在横截面上观察年龄对这些特征的影响。
方法：SARP III是国家卫生研究院/国家心脏肺血液研究所多站点3年队列研究，旨在调查重症哮喘的机制。样本包括188名儿童（111名重度，77名非重度）和526名成年人（313名重度，213名非重度），其特征是根据年龄和严重程度比较人口特征，症状，保健利用，肺功能和炎症标志。
结果:与非重症哮喘儿童相比，重症哮喘儿童症状更多，发作次数多，但体重，支气管扩张剂后肺功能或炎症标志物无差异。儿童期后，随着年龄的增长，队列中妇女比例较高，过敏原敏感性降低，血嗜酸性粒细胞总体减少。与非重症哮喘患者相比，重症哮喘患者年龄较大，肥胖，气道受限明显，血嗜酸性粒细胞较高的中年人入院率最高，但过敏原敏感性较低。
结论：哮喘的表型特征随着严重程度和年龄的增长而不同。随着年龄的增长，重症哮喘患者更加肥胖，气流受限更严重，过敏原敏感性降低，变异2型炎症反应。2型炎症途径之外的新机制可能预示随着年龄增长的重症哮喘表型。
(中日友好医院呼吸与危重症医学科 王瑞茵 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2017 Aug 30. pii: S2213-2198(17)30526-3. doi: 10.1016/j.jaip.2017.05.032. [Epub ahead of print])
(J Allergy Clin Immunol Pract. 2017 Aug 30. pii: S2213-2198(17)30526-3. doi: 10.1016/j.jaip.2017.05.032. [Epub ahead of print])
Baseline Features of the Severe Asthma Research Program (SARP III) Cohort: Differences with Age.
Teague WG1, Phillips BR2, Fahy JV3, Wenzel SE4, Fitzpatrick AM5, Moore WC6, Hastie AT6, Bleecker ER6, Meyers DA6, Peters SP6, Castro M7, Coverstone AM7, Bacharier LB7, Ly NP3, Peters MC3, Denlinger LC8, Ramratnam S8, Sorkness RL8, Gaston BM9, Erzurum SC10, Comhair SAA10, Myers RE9, Zein J10, DeBoer MD11, Irani AM12, Israel E13, Levy B13, Cardet JC13, Phipatanakul W13, Gaffin JM13, Holguin F4, Fajt ML4, Aujla SJ4, Mauger DT2, Jarjour NN8.
Abstract
BACKGROUND AND OBJECTIVES:The effect of age on asthma severity is poorly understood. The objective of this study was to compare the baseline features of severe and nonsevere asthma in the Severe Asthma Research Program (SARP) III cohort, and examine in cross section the effects of age on those features.
METHODS:SARP III is a National Institutes of Health/National Heart Lung Blood Institute multisite 3-year cohort study conducted to investigate mechanisms of severe asthma. The sample included 188 children (111 severe, 77 nonsevere) and 526 adults (313 severe, 213 nonsevere) characterized for demographic features, symptoms, health care utilization, lung function, and inflammatory markers compared by age and severity.
RESULTS:Compared with children with nonsevere asthma, children with severe asthma had more symptoms and more historical exacerbations, but no difference in body weight, post-bronchodilator lung function, or inflammatory markers. After childhood, and increasing with age, the cohort had a higher proportion of women, less allergen sensitization, and overall fewer blood eosinophils. Enrollment of participants with severe asthma was highest in middle-aged adults, who were older, more obese, with greater airflow limitation and higher blood eosinophils, but less allergen sensitization than adults with nonsevere asthma.
CONCLUSIONS:The phenotypic features of asthma differ by severity and with advancing age. With advancing age, patients with severe asthma are more obese, have greater airflow limitation, less allergen sensitization, and variable type 2 inflammation. Novel mechanisms besides type 2 inflammatory pathways may inform the severe asthma phenotype with advancing age.
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环境空气污染，交通噪音和成人哮喘的患病率:一个BioSHaRE研究
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社区的重症哮喘与非重症哮喘：一项大型电子数据库分析研究
