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      Baseline Features of the Severe Asthma Research Program (SARP III) Cohort: Differences with Age

      , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
      The Journal of Allergy and Clinical Immunology: In Practice
      Elsevier BV

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d7168152e502">Background</h5> <p id="P1">The effect of age on asthma severity is poorly understood.</p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <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. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <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. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <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. </p> </div><div class="section"> <a class="named-anchor" id="S5"> <!-- named anchor --> </a> <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. </p> </div>

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          Author and article information

          Journal
          The Journal of Allergy and Clinical Immunology: In Practice
          The Journal of Allergy and Clinical Immunology: In Practice
          Elsevier BV
          22132198
          March 2018
          March 2018
          : 6
          : 2
          : 545-554.e4
          Article
          10.1016/j.jaip.2017.05.032
          5832534
          28866107
          e23c647c-5a28-46be-83ff-b4ba8b53d989
          © 2018

          http://www.elsevier.com/tdm/userlicense/1.0/

          http://creativecommons.org/licenses/by-nc-nd/4.0/

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