Caminati Marco, Marcon Alessandro, Vaia Rachele, Senna Gianenrico, Maule Matteo, Marchetti Pierpaolo, Miotti Jessica, Argentino Giuseppe, Blasi Francesco, Canonica Giorgio W, Heffler Enrico M, Paggiaro Pierluigi, Vianello Andrea, Guarnieri Gabriella
Department of Medicine, University of Verona, Verona, Italy.
Asthma Center and Allergy Unit, Verona University Hospital, Verona, Italy.
World Allergy Organ J. 2024 Jul 29;17(8):100941. doi: 10.1016/j.waojou.2024.100941. eCollection 2024 Aug.
Aging implies changes in terms of lung function, immune system, and respiratory and extra-respiratory comorbidities. Few studies have specifically addressed the relevance of age on severe asthma burden and control. We aimed to evaluate whether age acts as an independent determinant of asthma severity, in terms of clinical, functional, and inflammatory profile, and to explore potential cofactors that contribute to a more difficult disease control in different age groups.
Patients from Severe Asthma Network Italy (SANI) registry were retrospectively divided in subgroups according to their age. Cutoffs for age were established according to quartiles in order to obtain a comparable number of patients for each group, and then rounded for the sake of simplicity.
Overall, 1805 severe asthma patients were analyzed. Lung function represented the most important age-related variable. On the opposite the level of asthma control was not differently distributed among age ranges. In young people the presence of atopy-related comorbidities (allergic rhinitis, atopic dermatitis) predominated, whilst systemic-metabolic and degenerative comorbidities such as diabetes, cardiovascular diseases, anxious-depressive syndrome, and osteoporosis prevailed in elderly. Bronchiectasis and sleep disturbances were significantly associated with age.
Despite that it cannot be considered a treatable trait, our study suggests that age should be evaluated within a personalized approach to severe asthma patients, in order to provide a better clinical profiling and a more tailored treatment strategy.
衰老意味着肺功能、免疫系统以及呼吸和呼吸外合并症方面的变化。很少有研究专门探讨年龄对重度哮喘负担和控制的相关性。我们旨在评估年龄是否作为哮喘严重程度的独立决定因素，从临床、功能和炎症特征方面进行评估，并探索导致不同年龄组疾病控制更困难的潜在辅助因素。
来自意大利重度哮喘网络（SANI）登记处的患者根据年龄进行回顾性分组。根据四分位数确定年龄界限，以便每组获得可比数量的患者，然后为了简化进行四舍五入。
总体上，分析了1805例重度哮喘患者。肺功能是与年龄相关的最重要变量。相反，哮喘控制水平在各年龄范围之间分布并无差异。在年轻人中，与特应性相关的合并症（过敏性鼻炎、特应性皮炎）占主导，而在老年人中，系统性代谢和退行性合并症如糖尿病、心血管疾病、焦虑抑郁综合征和骨质疏松症更为常见。支气管扩张和睡眠障碍与年龄显著相关。
尽管年龄不能被视为一种可治疗的特征，但我们的研究表明，在对重度哮喘患者进行个性化治疗时应评估年龄，以便提供更好的临床概况和更具针对性的治疗策略。
