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<h5 class="section-title" id="d7168152e502">Background</h5>
<p id="P1">The effect of age on asthma severity is poorly understood.</p>
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<h5 class="section-title" id="d7168152e507">Objectives</h5>
<p id="P2">To compare the baseline features of severe and non-severe asthma in the
SARP III cohort,
and examine in cross section the effects of age on those features.
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<h5 class="section-title" id="d7168152e512">Methods</h5>
<p id="P3">SARP III is an NIH/NHLBI multi-site 3 year cohort study conducted to investigate
mechanisms
of severe asthma. The sample included 188 children (111 severe, 77 non-severe) and
526 adults (313 severe, 213 non-severe) characterized for demographic features, symptoms,
health care utilization, lung function, and inflammatory markers compared by age and
severity.
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<h5 class="section-title" id="d7168152e517">Results</h5>
<p id="P4">Compared to children with non-severe asthma, children with severe asthma
had more
symptoms and more historical exacerbations, but no difference in body weight, post-bronchodilator
lung function, or inflammatory markers. After childhood, and increasing with age,
the cohort had a higher proportion of women, less allergen sensitization, and overall
fewer blood eosinophils. Enrollment of participants with severe asthma was highest
in middle-age adults, who were older, more obese, with greater airflow limitation
and higher blood eosinophils, but less allergen sensitization than adults with non-severe
asthma.
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<h5 class="section-title" id="d7168152e522">Conclusions</h5>
<p id="P5">The phenotypic features of asthma differ by severity and with advancing
age. With
advancing age, patients with severe asthma are more obese, have greater airflow limitation,
less allergen sensitization, and variable type 2 inflammation. Novel mechanisms besides
type 2 inflammatory pathways may inform the severe asthma phenotype with advancing
age.
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