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      Relationship between aeroallergen sensitization pattern and clinical features in adult asthmatics

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          Abstract

          Background

          Asthma can be classified into atopic and non-atopic phenotypes. However, limited data are available on the clinical implications of these two phenotypes in real life.

          Objective

          This study aimed to examine the clinical features as well as control level and disease severity of asthmatic patients with their aeroallergen sensitivity profiles.

          Methods

          Between 2013 and 2020, adult asthmatic patients who had been followed up regularly at our tertiary healthcare institution for at least one year were included in the study. We collected data retrospectively using manually filled patient files.

          Results

          The mean age of 382 asthmatic patients was 46.6 ± 30.0; 77.5% were women and 75.6% had at least one aeroallergen sensitivity. Polysensitized asthmatics had better asthma symptom control and milder asthma severity than monosensitized asthmatics. Asthma symptom control status was well controlled in 67.5% of the patients, and according to asthma severity, 51.3% of the patients were classified as having moderate asthma. There was a negative relation between age (OR:0.95, CI:0.92–0.98) and atopy presence. The presence of atopy was higher in moderate asthmatics than in mild asthmatics (OR:2.02, CI:1.01–4.09). Finally, there was a positive relationship between the percent predicted forced expiratory volume in first second (FEV 1%) (OR:1.02, CI:1.009–1.048) and the presence of atopy. The presence of rhinitis (OR:0.44, CI:0.22–0.88) and per 1 unit increase of Tiffeneau index (FEV 1/forced vital capacity) (OR:0.94, CI:0.90–0.99) had a negative association, whereas number of medication use for asthma symptoms (OR:1.68, CI:1.18–2.39) and presence of cardiovasculary disease (OR:2.64, CI:1.19–5.84) had a positive association with not well-controlled asthma symptom level.

          Conclusion

          Aeroallergen sensitivity was associated with asthma severity. However, this was not the case with asthma control levels in this adult asthma cohort. Among the atopic asthmatics polysensitized asthmatics had better asthma symptom control level and milder asthma severity level.

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          Most cited references27

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          Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute's Severe Asthma Research Program.

          Severe asthma causes the majority of asthma morbidity. Understanding mechanisms that contribute to the development of severe disease is important. The goal of the Severe Asthma Research Program is to identify and characterize subjects with severe asthma to understand pathophysiologic mechanisms in severe asthma. We performed a comprehensive phenotypic characterization (questionnaires, atopy and pulmonary function testing, phlebotomy, exhaled nitric oxide) in subjects with severe and not severe asthma. A total of 438 subjects with asthma were studied (204 severe, 70 moderate, 164 mild). Severe subjects with asthma were older with longer disease duration (P or = 12 years) was associated with lower lung function and sinopulmonary infections (P < or = .02). Severe asthma is characterized by abnormal lung function that is responsive to bronchodilators, a history of sinopulmonary infections, persistent symptoms, and increased health care utilization. Lung function abnormalities in severe asthma are reversible in most patients, and pneumonia is a risk factor for the development of severe disease.
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            Determinants and impact of suboptimal asthma control in Europe: The INTERNATIONAL CROSS-SECTIONAL AND LONGITUDINAL ASSESSMENT ON ASTHMA CONTROL (LIAISON) study

            Background According to the Global Initiative of Asthma, the aim of asthma treatment is to gain and maintain control. In the INTERNATIONAL CROSS-SECTIONAL AND LONGITUDINAL ASSESSMENT ON ASTHMA CONTROL (LIAISON) study, we evaluated the level of asthma control and quality of life (QoL), as well as their determinants and impact in a population consulting specialist settings. Methods LIAISON is a prospective, multicentre, observational study with a cross-sectional and a 12-month longitudinal phase. Adults with an asthma diagnosis since at least 6 months, receiving the same asthma treatment in the 4 weeks before enrolment were included. Asthma control was assessed with the 6-item Asthma Control Questionnaire (ACQ) and QoL with the MiniAsthma Quality of Life Questionnaire (MiniAQLQ). Results Overall, 8111 asthmatic patients were enrolled in 12 European countries. Asthma control was suboptimal in 56.5 % of patients and it was associated with poorer asthma-related QoL, higher risk of exacerbations and greater consumption of healthcare resources. Variables associated with suboptimal control were age, gender, obesity, smoking and comorbidities. Major determinants of poor asthma control were seasonal worsening and persisting exposure to allergens/irritants/triggers, followed by treatment-related issues. Conclusions The cross-sectional phase results confirm that suboptimal control is frequent and has a high individual and economic impact. Trial registration The clinicaltrials.gov identifier is NCT01567280. Electronic supplementary material The online version of this article (doi:10.1186/s12931-016-0374-z) contains supplementary material, which is available to authorized users.
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              Spirometry: step by step

              V.C. Moore (2012)
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                Author and article information

                Contributors
                Journal
                Heliyon
                Heliyon
                Heliyon
                Elsevier
                2405-8440
                25 April 2023
                May 2023
                25 April 2023
                : 9
                : 5
                : e15708
                Affiliations
                [a ]Department of Chest Diseases, Recep Tayyip Erdoğan University, School of Medicine, Rize, Turkey
                [b ]Department of Public Health, Recep Tayyip Erdoğan University, School of Medicine, Rize, Turkey
                [c ]Department of Immunology and Allergic Diseases, Recep Tayyip Erdoğan University, Rize, Turkey
                [d ]Department of Chest Diseases, Lokman Hekim University, School of Medicine, Ankara, Turkey
                Author notes
                []Corresponding author. dilek.karadogan@ 123456erdogan.edu.tr
                Article
                S2405-8440(23)02915-8 e15708
                10.1016/j.heliyon.2023.e15708
                10163641
                f31cb567-4710-4ee0-8485-942ab86f90b0
                © 2023 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 30 October 2022
                : 17 April 2023
                : 19 April 2023
                Categories
                Research Article

                asthma,aeroallergen sensitivity,non-atopic,atopic,asthma control,asthma severity

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