Respiratory Medicine CHU Sart-Tilman, University of Liege, Sart-Tilman Liege, B35, GIGA I3, Liege, Belgium.
Respir Res. 2021 Jan 13;22(1):15. doi: 10.1186/s12931-021-01619-w.
Elderly asthmatics represent an important group that is often excluded from clinical studies. In this study we wanted to present characteristics of asthmatics older than 70 years old as compared to younger patients.
We conducted a retrospective analysis on a series of 758 asthmatics subdivided in three groups: lower than 40, between 40 and 70 and older than 70. All the patients who had a successful sputum induction were included in the study.
Older patients had a higher Body Mass Index, had less active smokers and were more often treated with Long Acting anti-Muscarinic Agents. We found a significant increase in sputum neutrophil counts with ageing. There was no significant difference in blood inflammatory cell counts whatever the age group. Forced expiratory volume in one second (FEV) and FEV/FVC values were significantly lower in elderly who had lower bronchial hyperresponsiveness and signs of air trapping. We found a lower occurrence of the allergic component in advanced ages. Asthmatics older than 70 years old had later onset of the disease and a significant longer disease duration.
Our study highlights that asthmatics older than 70 years old have higher bronchial neutrophilic inflammation, a poorer lung function, signs of air trapping and lower airway variability. The role of immunosenescence inducing chronic low-grade inflammation in this asthma subtype remains to be elucidated.
老年哮喘患者是一个重要的群体，他们经常被排除在临床研究之外。在这项研究中，我们希望比较 70 岁以上和年轻患者的哮喘特征。
我们对 758 例哮喘患者进行了回顾性分析，将患者分为三组：<40 岁、40-70 岁和>70 岁。所有成功进行痰诱导的患者均纳入研究。
老年患者的体重指数更高，吸烟者较少，更常使用长效抗毒蕈碱药物。我们发现随着年龄的增长，痰中性粒细胞计数显著增加。无论年龄组如何，血液炎症细胞计数均无显著差异。在有较低支气管高反应性和空气潴留迹象的老年患者中，用力呼气量（FEV）和 FEV/FVC 值显著降低。我们发现，在高龄时，过敏成分的发生较低。70 岁以上的哮喘患者疾病发病较晚，病程明显延长。
我们的研究表明，70 岁以上的哮喘患者存在更高的支气管中性粒细胞炎症、更差的肺功能、空气潴留迹象和较低的气道变异性。免疫衰老导致慢性低度炎症在这种哮喘亚型中的作用仍有待阐明。
