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Treatable Traits in Elderly Asthmatics from the Australasian Severe Asthma Network: A Prospective Cohort Study

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单位: [1]Sichuan Univ, Natl Clin Res Ctr Geriatr, Dept Integrated Tradit Chinese & Western Med, Pneumol Grp,West China Hosp, Chengdu, Sichuan, Peoples R China [2]Sichuan Univ, West China Hosp, Clin Res Ctr Resp Dis, Dept Resp & Crit Care Med, Chengdu 610041, Sichuan, Peoples R China [3]Sichuan Univ, Frontiers Sci Ctr Dis Related Mol Network, Lab Pulm Immunol & Inflammat, Chengdu, Sichuan, Peoples R China [4]Fudan Univ, Shanghai Inst Resp Dis, Resp Div, Zhongshan Hosp, Shanghai, Peoples R China [5]Huazhong Univ Sci & Technol, Tongji Hosp, Dept Resp & Crit Care Med, Wuhan, Peoples R China [6]Sichuan Univ, West China Hosp, Outpatient Dept, Chengdu, Sichuan, Peoples R China [7]Sichuan Univ, West China Sch Med, Chengdu, Peoples R China [8]Karolinska Inst, Inst Environm Med, Stockholm, Sweden [9]Karolinska Inst, Dept Clin Sci & Educ, Sodersjukhuset, Stockholm, Sweden [10]Cent South Univ, Xiangya Hosp, Dept Resp & Crit Care Med, Changsha, Peoples R China [11]Univ Technol Sydney, Sch Life Sci, Ultimo, NSW, Australia [12]Univ Sydney, Woolcock Inst Med Res, Sydney, NSW, Australia [13]Second Hosp Jilin Univ, Dept Resp & Crit Care Med, Changchun, Peoples R China [14]Univ Newcastle, Hunter Med Res Inst, Prior Res Ctr Hlth Lungs, Newcastle, NSW, Australia [15]Sichuan Univ, Frontiers Sci Ctr Dis Related Mol Network, Resp Microbiome Lab, Chengdu, Sichuan, Peoples R China [16]Kings Coll London, Sch Basic & Med Biosci, Fac Life Sci & Med, Ctr Human & Appl Physiol Sci, London, England
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关键词: Asthma Elderly Treatable traits Exacerbation Prediction model The Australasian Severe Asthma Network

摘要:
BACKGROUND: Data on treatable traits (TTs) in different populations are limited. OBJECTIVE: To assess TTs in elderly patients with asthma and compare them to younger patients, to evaluate the association of TTs with future exacerbations, and to develop an exacerbation prediction model. METHODS: We consecutively recruited 521 participants at West China Hospital, Sichuan University based on theAustralasian Severe Asthma Network, classified as elderly (n = 62) and nonelderly (n = 459). Participants underwent a multidimensional assessment to characterize the TTs and were then followed up for 12 months. TTs and their relationship with future exacerbations were described. Based on the TTs and asthma control levels, an exacerbation prediction model was developed, and the overall performance was externally validated in an independent cohort. RESULTS: A total of 38 TTs were assessed. Elderly patients with asthma had more chronic metabolic diseases, fixed airflow limitation, emphysema, and neutrophilic inflammation, whereas nonelderly patients with asthma exhibited more allergic characteristics and psychiatric diseases. Nine traits were associated with increased future exacerbations, of which exacerbation prone, upper respiratory infection -induced asthma attack, cardiovascular disease, diabetes, and depression were the strongest. A model including exacerbation prone, psychiatric disease, cardiovascular disease, upper respiratory infection -induced asthma attack, noneosinophilic inflamma-tion, cachexia, food allergy, and asthma control was developed to predict exacerbation risk and showed good performance. CONCLUSIONS: TTs can be systematically assessed in elderly patients with asthma, some of which are associated with future exacerbations, proving their clinical utility of evaluating them. A model based on TTs can be used to predict exacerbation risk in people with asthma. (c) 2021 American Academy of Allergy, Asthma & Immunology (J Allergy Clin Immunol Pract 2021;9:2770-82)

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出版当年[2020]版:
大类 | 1 区 医学
小类 | 1 区 过敏 2 区 免疫学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 免疫学 2 区 过敏
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出版当年[2019]版:
Q1 IMMUNOLOGY Q1 ALLERGY
最新[2023]版:
Q1 ALLERGY Q1 IMMUNOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版] 出版后一年[2020版]

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第一作者单位: [1]Sichuan Univ, Natl Clin Res Ctr Geriatr, Dept Integrated Tradit Chinese & Western Med, Pneumol Grp,West China Hosp, Chengdu, Sichuan, Peoples R China [2]Sichuan Univ, West China Hosp, Clin Res Ctr Resp Dis, Dept Resp & Crit Care Med, Chengdu 610041, Sichuan, Peoples R China [3]Sichuan Univ, Frontiers Sci Ctr Dis Related Mol Network, Lab Pulm Immunol & Inflammat, Chengdu, Sichuan, Peoples R China
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通讯机构: [1]Sichuan Univ, Natl Clin Res Ctr Geriatr, Dept Integrated Tradit Chinese & Western Med, Pneumol Grp,West China Hosp, Chengdu, Sichuan, Peoples R China [2]Sichuan Univ, West China Hosp, Clin Res Ctr Resp Dis, Dept Resp & Crit Care Med, Chengdu 610041, Sichuan, Peoples R China [3]Sichuan Univ, Frontiers Sci Ctr Dis Related Mol Network, Lab Pulm Immunol & Inflammat, Chengdu, Sichuan, Peoples R China [7]Sichuan Univ, West China Sch Med, Chengdu, Peoples R China [8]Karolinska Inst, Inst Environm Med, Stockholm, Sweden [9]Karolinska Inst, Dept Clin Sci & Educ, Sodersjukhuset, Stockholm, Sweden
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