Regional Center of Allergy and Clinical Immunology, Universidad Autonoma de Nuevo León.
World Allergy Organization Center of Excellence.
Curr Opin Allergy Clin Immunol. 2019 Jun;19(3):209-215. doi: 10.1097/ACI.0000000000000525.
Asthma is a chronic heterogeneous respiratory disease which is characterized by airflow limitation and variable respiratory symptoms. Asthma in patients more than 65 years of age has an important negative impact on quality of life. The pathophysiology and treatment of asthma in older patients are not as well identified as in younger groups of ages. In this review we intend to outline characteristics found in elderly adults which distinguish them from other age groups of patients with asthma.
With increasing age, there are alterations in the innate and adaptive immune responses, known as 'immunosenescence.' These age-associated modifications include an altered response after a pathogenic exposure or tissue injury, moderately mediated through an irreversible loss of cellular replication and defective tissue repair.
Asthma is a consequence of complex gene-environment interactions, with diversity in clinical presentation and the type and intensity of airway inflammation and remodeling. Age-associated changes in lung physiology and morphology may occur and contribute to asthma. Aging is correlated with a notable decrease in elastic recoil, greater chest wall rigidity, and poor respiratory muscle strength. Underreporting of symptoms by elderly patients is common because of multiple underlying causes. VIDEO ABSTRACT: http://links.lww.com/COAI/A17.
哮喘是一种慢性异质性呼吸道疾病，其特征是气流受限和可变的呼吸道症状。65 岁以上患者的哮喘对生活质量有重要的负面影响。老年患者哮喘的病理生理学和治疗方法不如年轻患者群体明确。在这篇综述中，我们旨在概述老年人中发现的特征，将他们与其他年龄组的哮喘患者区分开来。
随着年龄的增长，先天和适应性免疫反应发生改变，称为“免疫衰老”。这些与年龄相关的改变包括在发病后或组织损伤后的反应改变，中度介导通过细胞复制的不可逆丧失和组织修复缺陷。
哮喘是复杂的基因-环境相互作用的结果，其临床表现、气道炎症和重塑的类型和强度存在多样性。肺生理学和形态的与年龄相关的变化可能发生，并导致哮喘。随着年龄的增长，弹性回缩明显减少，胸壁僵硬度增加，呼吸肌力量减弱。由于多种潜在原因，老年患者的症状常被漏报。
