Division of Allergy and Immunology, College of Medicine, University of South Florida, Tampa, Florida 7574, USA.
Curr Opin Pulm Med. 2010 Jan;16(1):55-9. doi: 10.1097/MCP.0b013e328333acb0.
Asthma is a common disease in the older population that is frequently undiagnosed and undertreated. We will review the current knowledge of asthma in the elderly (AIE) and shed light on the diagnostic and management challenges outlining needs for future research.
There has been very little original research in the field of AIE published in the last few years, and current literature focuses primarily on a series of review articles. AIE often presents with multiple comorbidities, which complicates its course and management. There is renewed interest in nonallergic (intrinsic) asthma. T helper cell 1 inflammation triggered by respiratory infection, superantigens, proteases and interleukin 17 are possible mechanisms. An association between systemic inflammation in frailty and asthma may also be important.
The diagnosis and treatment of AIE requires that the individual patient and his or her specific triggers and the likely pathophysiology be understood. Understanding the mechanisms of inflammation in this population is key to improved therapeutic interventions.
哮喘是老年人中常见的疾病，常被漏诊和治疗不足。我们将回顾老年人哮喘（AIE）的现有知识，并阐明诊断和管理方面的挑战，为未来的研究指明方向。
在过去几年中，AIE 领域几乎没有发表过任何原创研究，目前的文献主要集中在一系列综述文章上。AIE 常伴有多种合并症，这使其病程和管理复杂化。非过敏性（内在）哮喘再次受到关注。呼吸道感染、超抗原、蛋白酶和白细胞介素 17 引发的辅助性 T 细胞 1 炎症可能是其发病机制。在衰弱和哮喘之间，全身性炎症的关联可能也很重要。
AIE 的诊断和治疗需要了解个体患者及其特定的触发因素和可能的病理生理学。了解该人群炎症的机制是改善治疗干预的关键。
