PDF(Sci-hub)
Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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 (FEV1) and FEV1/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.
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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 (FEV1) and FEV1/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.
CONCLUSIONS: 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.
摘要：
背景：老年哮喘患者是一个重要的群体，通常被排除在临床研究之外。在这项研究中，我们希望展示70岁以上的哮喘患者与年轻患者相比的特征。
方法：我们对一系列758名哮喘患者进行了回顾性分析，分为三组：低于40岁，40至70岁以及70岁以上。所有成功诱导痰液的患者均纳入研究。
结果：老年患者的体重指数较高，吸烟者活动较少，更经常使用长效抗毒蕈碱药治疗。我们发现痰中性粒细胞计数随着年龄的增长而显著增加。无论年龄组，血液炎症细胞计数均无明显差异。在支气管高反应性和空气滞留迹象较低的老年人中，一秒钟的用力呼气量（FEV1）和FEV1/FVC值显着降低。我们发现老年人过敏成分的发生率较低。70岁以上的哮喘患者的疾病发作较晚，疾病持续时间明显更长。
结论：我们的研究强调，70岁以上的哮喘患者有更高的支气管中性粒细胞炎症，肺功能较差，空气滞留和低气道变异性的迹象。免疫衰老在这种哮喘亚型中诱导慢性低度炎症的作用仍有待阐明。
方法：我们对一系列758名哮喘患者进行了回顾性分析，分为三组：低于40岁，40至70岁以及70岁以上。所有成功诱导痰液的患者均纳入研究。
结果：老年患者的体重指数较高，吸烟者活动较少，更经常使用长效抗毒蕈碱药治疗。我们发现痰中性粒细胞计数随着年龄的增长而显著增加。无论年龄组，血液炎症细胞计数均无明显差异。在支气管高反应性和空气滞留迹象较低的老年人中，一秒钟的用力呼气量（FEV1）和FEV1/FVC值显着降低。我们发现老年人过敏成分的发生率较低。70岁以上的哮喘患者的疾病发作较晚，疾病持续时间明显更长。
结论：我们的研究强调，70岁以上的哮喘患者有更高的支气管中性粒细胞炎症，肺功能较差，空气滞留和低气道变异性的迹象。免疫衰老在这种哮喘亚型中诱导慢性低度炎症的作用仍有待阐明。
