Asia Pac Allergy.  2016 Jul;6(3):181-186. 10.5415/apallergy.2016.6.3.181.

Role of eosinophilic inflammation and atopy in elderly asthmatic patients

• Kawamatawong T
• Siripongpun S
• Rerkpattanapipat T

• KMID: 2400420
• DOI: http://doi.org/10.5415/apallergy.2016.6.3.181

Abstract

BACKGROUND
Asthma in the elderly is severe and associated with poor treatment outcome. Although atopy has an important role in pathogenesis, its role in the elderly is unclear, partly due to immune senescence.
OBJECTIVE
We aimed to examine the associations of Th2-mediated inflammation with asthma severity in the elderly.
METHODS
Consecutive asthmatics older than 60 years without severe exacerbation within 8 weeks were enrolled. Atopic status was determined by positive serum specific IgE or skin prick test to common aeroallergens. Serum total IgE was measured simultaneously to exhaled fractional concentration of nitric oxide (FeNO). Asthma control level was assessed by using Thai Asthma Control Test (ACT) score.
RESULTS
Total of 44 elderly asthmatic patients were enrolled. The mean age was 68.9 years and mean age of asthma diagnosis was 46.6 years. Seventy-seven percent of patients were female. Atopic status was found in 45.5% of patients. Uncontrolled asthma classified as ACT score < 20 was noted in 25% of elderly asthma, but its association with either high serum total IgE (≥120 IU/mL), high FeNO (≥50 ppb) or atopic status was not detected.
CONCLUSION
One-fourth of elderly asthmatics were clinically uncontrolled, while atopy was confirmed in 45.5%. Neither high total IgE, high FeNO nor atopic status was associated with uncontrolled asthma in the elderly. Other factors might play role in asthma severity in the elderly, and has to be further investigated.

Keyword

Asthma control; Atopy; Elderly; Eosinophilic inflammation

MeSH Terms

Aged*
Aging
Asian Continental Ancestry Group
Asthma
Diagnosis
Eosinophils*
Female
Humans
Immunoglobulin E
Inflammation*
Nitric Oxide
Skin
Treatment Outcome
Immunoglobulin E
Nitric Oxide

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