Tuberc Respir Dis.  2017 Apr;80(2):113-135. 10.4046/trd.2017.80.2.113.

Asthma and the Risk of Rheumatoid Arthritis: An Insight into the Heterogeneity and Phenotypes of Asthma

Affiliations
  • 1Mayo Medical School, Rochester, MN, USA.
  • 2Department of Pediatric and Adolescent Medicine/Internal Medicine, Mayo Clinic, Rochester, MN, USA.
  • 3Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA. epirubicin13@gmail.com
  • 4Department of Pediatrics, CHA Gangnam Medical Center, CHA University, Seoul, Korea.

Abstract

Asthma is traditionally regarded as a chronic airway disease, and recent literature proves its heterogeneity, based on distinctive clusters or phenotypes of asthma. In defining such asthma clusters, the nature of comorbidity among patients with asthma is poorly understood, by assuming no causal relationship between asthma and other comorbid conditions, including both communicable and noncommunicable diseases. However, emerging evidence suggests that the status of asthma significantly affects the increased susceptibility of the patient to both communicable and noncommunicable diseases. Specifically, the impact of asthma on susceptibility to noncommunicable diseases such as chronic systemic inflammatory diseases (e.g., rheumatoid arthritis), may provide an important insight into asthma as a disease with systemic inflammatory features, a conceptual understanding between asthma and asthma-related comorbidity, and the potential implications on the therapeutic and preventive interventions for patients with asthma. This review discusses the currently under-recognized clinical and immunological phenotypes of asthma; specifically, a higher risk of developing a systemic inflammatory disease such as rheumatoid arthritis and their implications, on the conceptual understanding and management of asthma. Our discussion is divided into three parts: literature summary on the relationship between asthma and the risk of rheumatoid arthritis; potential mechanisms underlying the association; and implications on asthma management and research.

Keyword

Asthma; Arthritis, Rheumatoid; Risk; Comorbidity; Epidemiology; Genetic Heterogeneity; Phenotype

MeSH Terms

Arthritis, Rheumatoid*
Asthma*
Comorbidity
Epidemiology
Genetic Heterogeneity
Humans
Phenotype*
Population Characteristics*

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