Paula J Busse1, Janette M Birmingham2, Agustin Calatroni3, Joseph Manzi2, Anna Goryachokovsky2, Giselle Fontela2, Alex D Federman4, Juan P Wisnivesky5. 1. Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: paula.busse@mssm.edu. 2. Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, NY. 3. Rho, Federal Systems Division, Chapel Hill, NC. 4. Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. 5. Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Abstract
BACKGROUND: Aged asthmatic patients experience increased morbidity and mortality. Knowledge of the aging effect on airway inflammation and asthma control is limited. OBJECTIVE: We sought to compare airway inflammation and its relationship to asthma control in aged versus younger patients and determine whether differences are asthma specific or caused by "inflamm-aging." METHODS: We performed a prospective study of aged (>60 years) and younger (21-40 years) inner-city patients with asthma. After a run-in period to control for inhaled corticosteroid use, induced sputum was collected. Age-matched nonasthmatic control subjects were included to measure age-related inflammatory changes. RESULTS: Aged (mean age, 67.9 ± 5.1 years; n = 35) compared with younger (mean age, 30.8 ± 5.9 years; n = 37) asthmatic patients had significantly worse asthma control and lower FEV1. Aged asthmatic patients had higher sputum neutrophil (30.5 × 104/mL and 23.1%) and eosinophil (7.0 × 104/mL and 3.8%) numbers and percentages compared with younger patients (neutrophils, 13.0 × 104/mL [P < .01] and 6.9% [P < .01]; eosinophils, 2.0 × 104/mL [P < .01] and 1.2% [P < .01]). Aged asthmatic patients had higher sputum IL-6 (P < .01) and IL-8 (P = .01) levels. No significant inflammatory differences between aged and younger control subjects were observed. In aged asthmatic patients increased sputum IL-6 and macrophage inflammatory protein 3α/CCL20 levels were significantly associated with decreased asthma control and increased sputum neutrophil numbers and IL-1β, IL-6, and macrophage inflammatory protein 3α/CCL20 levels were associated with hospitalization. CONCLUSIONS: The inflammatory patterns of aged versus younger asthmatic patients are associated with increased sputum neutrophil and eosinophil values and cytokine levels related to neutrophil recruitment. Differences in airway inflammation can contribute to diminished asthma control in the aged. Further understanding of asthma pathophysiology in aged patients is needed to improve management of this vulnerable population.
BACKGROUND: Aged asthmatic patients experience increased morbidity and mortality. Knowledge of the aging effect on airway inflammation and asthma control is limited. OBJECTIVE: We sought to compare airway inflammation and its relationship to asthma control in aged versus younger patients and determine whether differences are asthma specific or caused by "inflamm-aging." METHODS: We performed a prospective study of aged (>60 years) and younger (21-40 years) inner-city patients with asthma. After a run-in period to control for inhaled corticosteroid use, induced sputum was collected. Age-matched nonasthmatic control subjects were included to measure age-related inflammatory changes. RESULTS: Aged (mean age, 67.9 ± 5.1 years; n = 35) compared with younger (mean age, 30.8 ± 5.9 years; n = 37) asthmatic patients had significantly worse asthma control and lower FEV1. Aged asthmatic patients had higher sputum neutrophil (30.5 × 104/mL and 23.1%) and eosinophil (7.0 × 104/mL and 3.8%) numbers and percentages compared with younger patients (neutrophils, 13.0 × 104/mL [P < .01] and 6.9% [P < .01]; eosinophils, 2.0 × 104/mL [P < .01] and 1.2% [P < .01]). Aged asthmatic patients had higher sputum IL-6 (P < .01) and IL-8 (P = .01) levels. No significant inflammatory differences between aged and younger control subjects were observed. In aged asthmatic patients increased sputum IL-6 and macrophage inflammatory protein 3α/CCL20 levels were significantly associated with decreased asthma control and increased sputum neutrophil numbers and IL-1β, IL-6, and macrophage inflammatory protein 3α/CCL20 levels were associated with hospitalization. CONCLUSIONS: The inflammatory patterns of aged versus younger asthmatic patients are associated with increased sputum neutrophil and eosinophil values and cytokine levels related to neutrophil recruitment. Differences in airway inflammation can contribute to diminished asthma control in the aged. Further understanding of asthma pathophysiology in aged patients is needed to improve management of this vulnerable population.
Authors: Aysefa Doganci; Tatjana Eigenbrod; Norbert Krug; George T De Sanctis; Michael Hausding; Veit J Erpenbeck; El-Bdaoui Haddad; Hans A Lehr; Edgar Schmitt; Tobias Bopp; Karl-J Kallen; Udo Herz; Steffen Schmitt; Cornelia Luft; Olaf Hecht; Jens M Hohlfeld; Hiroaki Ito; Norihiro Nishimoto; Kazuyuki Yoshizaki; Tadamitsu Kishimoto; Stefan Rose-John; Harald Renz; Markus F Neurath; Peter R Galle; Susetta Finotto Journal: J Clin Invest Date: 2005-02 Impact factor: 14.808
Authors: Christine K Liu; Asya Lyass; Martin G Larson; Joseph M Massaro; Na Wang; Ralph B D'Agostino; Emelia J Benjamin; Joanne M Murabito Journal: Age (Dordr) Date: 2015-12-23
Authors: Lucie Roussel; François Houle; Carlos Chan; Yu Yao; Julie Bérubé; Ron Olivenstein; James G Martin; Jacques Huot; Qutayba Hamid; Lorenzo Ferri; Simon Rousseau Journal: J Immunol Date: 2010-03-12 Impact factor: 5.422
Authors: Ilona Kryczek; Ende Zhao; Yan Liu; Yin Wang; Linhua Vatan; Wojciech Szeliga; Jeffrey Moyer; Aleksandra Klimczak; Andrzej Lange; Weiping Zou Journal: Sci Transl Med Date: 2011-10-12 Impact factor: 17.956
Authors: Laura Tsaknaridis; Leslie Spencer; Nicole Culbertson; Kevin Hicks; Dorian LaTocha; Yuan K Chou; Ruth H Whitham; Antony Bakke; Richard E Jones; Halina Offner; Dennis N Bourdette; Arthur A Vandenbark Journal: J Neurosci Res Date: 2003-10-15 Impact factor: 4.164
Authors: Gregory A Hawkins; Mac B Robinson; Annette T Hastie; Xingnan Li; Huashi Li; Wendy C Moore; Timothy D Howard; William W Busse; Serpil C Erzurum; Sally E Wenzel; Stephen P Peters; Deborah A Meyers; Eugene R Bleecker Journal: J Allergy Clin Immunol Date: 2012-05-01 Impact factor: 14.290
Authors: Charles F Schuler; Carrie-Anne Malinczak; Shannon K K Best; Susan B Morris; Andrew J Rasky; Catherine Ptaschinski; Nicholas W Lukacs; Wendy Fonseca Journal: Allergy Date: 2020-05-15 Impact factor: 13.146
Authors: Pavan Parikh; Sarah Wicher; Karl Khandalavala; Christina M Pabelick; Rodney D Britt; Y S Prakash Journal: Am J Physiol Lung Cell Mol Physiol Date: 2019-02-20 Impact factor: 5.464
Authors: Osama A Kishta; Antoine Sabourin; Leora Simon; Toby McGovern; Maxime Raymond; Tristan Galbas; Abdelilah Majdoubi; Satoshi Ishido; James G Martin; Jacques Thibodeau Journal: J Immunol Res Date: 2018-05-03 Impact factor: 4.818