Schiffers Caspar, Wouters Emiel F M, Breyer-Kohansal Robab, Buhl Roland, Pohl Wolfgang, Irvin Charles G, Breyer Marie-Kathrin, Hartl Sylvia
Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.
NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands.
J Asthma Allergy. 2023 Apr 8;16:367-382. doi: 10.2147/JAA.S402326. eCollection 2023.
Asthma is a chronic heterogeneous respiratory disease involving differential pathophysiological pathways and consequently distinct asthma phenotypes.
In the LEAD Study, a general population cohort (n=11.423) in Vienna ranging from 6-82 years of age, we addressed the prevalence of asthma and explored inflammatory asthma phenotypes that included allergic and non-allergic asthma, and within these phenotypes, an eosinophilic (eosinophils ≥300 cells/µL, or ≥150 cells/µL in the presence of ICS medication) or non-eosinophilic (eosinophils <300 cells/µL, or <150 cells/µL in the presence of ICS) phenotype. In addition, we compared various factors related to biomarkers, body composition, lung function, and symptoms in control subjects versus subjects with current asthma (current doctor's diagnosis of asthma).
An overall prevalence of 4.6% was observed for current asthma. Furthermore, an age-dependent shift from allergic to non-allergic asthma was found. The non-eosinophilic phenotype was more prominent. Obesity was a prevalent condition, and body composition including visceral adipose tissue (VAT), is affected in current asthma versus controls.
This broad-aged and large general population cohort identified differential patterns of inflammatory asthma phenotypes that were age-dependent. The presence of eosinophilia was associated with worse asthma control, increased asthma medication, increased VAT, and lower lung function, the opposite was found for the presence of an allergic asthma.
哮喘是一种慢性异质性呼吸系统疾病，涉及不同的病理生理途径，因此有不同的哮喘表型。
在LEAD研究中，我们对维也纳年龄在6至82岁的11423名普通人群队列进行了研究，探讨哮喘的患病率，并探索炎症性哮喘表型，包括过敏性和非过敏性哮喘，在这些表型中，又分为嗜酸性粒细胞性（嗜酸性粒细胞≥300个细胞/微升，或在使用吸入性糖皮质激素（ICS）药物时≥150个细胞/微升）或非嗜酸性粒细胞性（嗜酸性粒细胞<300个细胞/微升，或在使用ICS时<150个细胞/微升）表型。此外，我们比较了对照组与现患哮喘患者（目前医生诊断为哮喘）在生物标志物、身体组成、肺功能和症状等方面的各种因素。
现患哮喘的总体患病率为4.6%。此外，还发现了从过敏性哮喘到非过敏性哮喘的年龄依赖性转变。非嗜酸性粒细胞性表型更为突出。肥胖是一种普遍情况，与对照组相比，现患哮喘患者的身体组成包括内脏脂肪组织（VAT）受到影响。
这个年龄跨度大的大型普通人群队列确定了炎症性哮喘表型的不同模式，这些模式具有年龄依赖性。嗜酸性粒细胞增多与哮喘控制较差、哮喘药物使用增加、VAT增加和肺功能降低有关，而过敏性哮喘则相反。
