Clinical phenotypes of asthma

Current Opinion in Pulmonary Medicine

Volumn 10, Issue 1, 2004, Pages 44-50

  Bel, Elisabeth H ^a  

^a LEIDEN UNIVERSITY MEDICAL CENTER   (Netherlands)

Author keywords

Adult onset asthma; Childhood asthma; Phenotypes; Severe asthma

Indexed keywords

ACETYLSALICYLIC ACID; ACYLTRANSFERASE; BCG VACCINE; CELECOXIB; CHLORINE; CORTICOSTEROID; GLUCOCORTICOID; IMMUNOGLOBULIN E; NONSTEROID ANTIINFLAMMATORY AGENT; STEROID; TOLUENE DIISOCYANATE;

ACCURACY; ADULT ONSET ASTHMA; AIRWAY OBSTRUCTION; ALLERGY; ASPIRIN INDUCED ASTHMA; ASTHMA; ATOPY; CLINICAL FEATURE; CONSERVATIVE TREATMENT; DIFFERENTIAL DIAGNOSIS; DISEASE ASSOCIATION; DISEASE CLASSIFICATION; DISEASE DURATION; DISEASE SEVERITY; DRUG HYPERSENSITIVITY; DRUG TOLERABILITY; EOSINOPHIL; EOSINOPHILIA; EXPIRATORY FLOW; GENETIC ASSOCIATION; GENETIC PREDISPOSITION; GENOTYPE; HUMAN; IMMUNOGLOBULIN E MEDIATED ASTHMA; INFLAMMATION; LATE ONSET CHILDHOOD ASTHMA; LUNG FUNCTION; NONATOPIC WHEEZING; NONEOSINOPHILIC ASTHMA; OCCUPATIONAL ASTHMA; OCCUPATIONAL HAZARD; PARASITOSIS; PATHOGENESIS; PATHOPHYSIOLOGY; PHENOTYPE; PROGNOSIS; RESPIRATORY TRACT INFECTION; REVIEW; RISK FACTOR; SENSITIZATION; TRANSIENT INFANT WHEEZING; TREATMENT OUTCOME; VACCINATION; VIRUS INFECTION; WHEEZING;

EID: 0346334385     PISSN: 10705287     EISSN: None     Source Type: Journal    
DOI: 10.1097/00063198-200401000-00008     Document Type: Review

References (76)

1. Martinez FD: Development of wheezing disorders and asthma in preschool children. Pediatrics 2002, 109(suppl 2):362-367.
2. Taussig LM, Wright AL, Holberg CJ, et al.: Tucson Children's Respiratory Study: 1980 to present. J Allergy Clin Immunol 2003, 111:661-675. This outstanding review summarizes the major findings from the Tucson Children's Respiratory Study from 1980 to 2002.
3. De Marco R, Locatelli F, Cerveri I, et al.: Incidence and remission of asthma: a retrospective study on the natural history of asthma in Italy. J Allergy Clin Immunol 2002, 110:228-235. This is one of the very few studies on incidence, persistence, and remission of asthma studied in a large sample of adults who took part in the multicenter Italian Study on Asthma in Young Adults.
4. Lau S, Illi S, Sommerfeld C, et al.: Transient early wheeze is not associated with impaired lung function in 7-yr-old children. Eur Respir J 2003, 21:834-841. This study describes the results of the German Multicenter Allergy Study in which 1314 children were followed from birth as long as 7 years. Children with transient wheeze during the first 3 years of life showed only minimal impairment of lung function at age 7 years. In persistent wheezers, impaired lung function was associated with a low weight index at birth, sensitization to indoor allergens, an atopic family history, and elevated cord-blood IgE levels.
5. Martinez FD: Respiratory syncytial virus bronchiolitis and the pathogenesis of childhood asthma. Pediatr Infect Dis J 2003, 22(suppl 2):S76-S82.
6. Bisgaard H: A randomized trial of montelukast in respiratory syncytial virus postbronchiolitis. Am J Respir Crit Care Med 2003, 167:379-383. This double-blind, placebo-controlled, parallel study of 130 infants hospitalized with acute respiratory syncytial virus bronchiolitis showed that 5 mg montelukast once daily significantly reduced cough and exacerbations.
7. Kurukulaaratchy RJ, Fenn MH, Waterhouse LM, et al.: Characterization of wheezing phenotypes in the first 10 years of life. Clin Exp Allergy 2003, 33:573-578. A whole population birth cohort of 1456 children was prospectively studied at 1,2, 4, and 10 years. Compared with transient wheezers, children with persistent wheeze experienced more hospital admissions, specialist referral, and use of inhaled and oral corticosteroids. They also demonstrated high levels of atopy, enhanced bronchial hyperresponsiveness, and impaired lung function
8. Lemanske RF Jr: Issues in understanding pediatric asthma: epidemiology and genetics. J Allergy Clin Immunol 2002, 109(suppl 6):S521-S524.
9. Platts-Mills TA: Paradoxical effect of domestic animals on asthma and allergic sensitization. JAMA 2002, 288:1012-1014.
10. Braun-Fahrlander C, Riedler J, Herz U, et al.: Environmental exposure to endotoxin and its relation to asthma in school-age children. N Engl J Med 2002, 347:869-877. This study of 812 children age 6 to 13 years (319 from farming families and 493 from nonfarming families) showed an inverse relationship between exposure to endotoxin levels in the bedding and the occurrence of childhood asthma and allergies as assessed by questionnaires and analysis of blood samples for atopy.
11. Ownby DR, Johnson CC, Peterson EL: Exposure to dogs and cats in the first year of life and risk of allergic sensitization at 6 to 7 years of age. JAMA 2002, 288:963-972. This prospective birth cohort study of 474 healthy infants showed that exposure to two or more dogs or cats during the first year of life was associated with a lower prevalence of allergic sensitization to multiple allergens at age 7 years.
12. Celedon JC, Litonjua AA, Ryan L, et al.: Exposure to cat allergen, maternal history of asthma, and wheezing in first 5 years of life. Lancet 2002, 360:781-782.
13. Litonjua AA, Milton DK, Celedon JC, et al.: A longitudinal analysis of wheezing in young children: the independent effects of early life exposure to house dust endotoxin, allergens, and pets. J Allergy Clin Immunol 2002, 110:736-742. In this study the effects of exposure to house dust endotoxin, allergens, and pet dogs on wheezing episodes during a 4-year period were examined in a cohort of children with a median age of 2.9 years. Exposure to cat allergen and the presence of a dog in the home were both associated with decreased risks for wheezing throughout the period of follow-up, unlike the risks associated with house dust endotoxin exposure, suggesting that separate mechanisms might mediate the effects of these exposures on the developing immune system.
14. Bach JF: The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med 2002, 347:911-920.
15. Yazdanbakhsh M, Kremsner PG, van Ree R: Allergy, parasites, and the hygiene hypothesis. Science 2002, 296:490-494.
16. Matricardi PM, Rosmini F, Panetta V, et al.: Hay fever and asthma in relation to markers of infection in the United States. J Allergy Clin Immunol 2002, 110:381-387. Analysis of the data of 33,994 US residents examined during the 1988 to 1994 Third National Health and Nutrition Examination Survey showed that Americans who acquired hepatitis A virus, Toxoplasma gondii, or herpes simplex virus type 1 infections experience less hay fever or asthma, and are less often sensitized to common airborne allergens and to peanuts.
17. Marks GB, Ng K, Zhou J, et al.: The effect of neonatal BCG vaccination on atopy and asthma at age 7 to 14 years: an historical cohort study in a community with a very low prevalence of tuberculosis infection and a high prevalence of atopic disease. J Allergy Clin Immunol 2003, 111:541-549.
18. Mallia P, Johnston SL: Respiratory viruses: do they protect from or induce asthma? Allergy 2002, 57:1118-1129.
19. Ernst P, Ghezzo H, Becklake MR: Risk factors for bronchial hyperresponsiveness in late childhood and early adolescence. Eur Respir J 2002, 20:635-639.
20. Phelan PD, Robertson CF, Olinsky A: The Melbourne Asthma Study: 1964-1999. J Allergy Clin Immunol 2002, 109:189-194.
21. Horak E, Lanigan A, Roberts M, et al.: Longitudinal study of childhood wheezy bronchitis and asthma: outcome at age 42. BMJ 2003, 326:422-423. This short paper describes the results of the Melbourne Epidemiological Study of Childhood Asthma. A group of 295 randomly selected children with asthma was followed from age 7 years through adolescence to adulthood. Children with persistent asthma had continuing symptoms into adult life and reduced lung function, whereas those with intermittent symptoms generally had complete resolution of symptoms in adult life and normal lung function.
22. Rackeman FM. A working classification of asthma. Am J Med 1947, 3:601-606.
23. Strachan DP, Butland BK, Anderson HR: Incidence and prognosis of asthma and wheezing illness from early childhood to age 33 in a national British cohort. BMJ 1996, 312:1195-1199.
24. Toren K, Olin AC, Hellgren J, et al.: Rhinitis increases the risk for adult-onset asthma-a Swedish population-based case-control study (MAP-study). Respir Med 2002, 96:635-641.
25. Hizawa N, Yamaguchi E, Konno S, et al.: A functional polymorphism in the RANTES gene promoter is associated with the development of late-onset asthma. Am J Respir Crit Care Med 2002, 166:686-690.
26. Knox AJ: How prevalent is aspirin induced asthma? Thorax 2002, 57:565-566.
27. Szczeklik A, Stevenson DD: Aspirin-induced asthma: advances in pathogenesis, diagnosis, and management. J Allergy Clin Immunol 2003, 111:913-921. This is a valuable review on different aspects of aspirin-sensitive asthma. The review includes clinical, pathophysiologic, and therapeutic issues.
28. Berges-Gimeno MP, Simon RA, Stevenson DD: Early effects of aspirin desensitization treatment in asthmatic patients with aspirin-exacerbated respiratory disease. Ann Allergy Asthma Immunol 2003, 90:338-341.
29. 1 receptor on leukocytes infiltrating the nasal mucosa, and a downregulation of these receptors after aspirin desensitization.
30. Namazy JA, Simon RA: Sensitivity to nonsteroidal anti-inflammatory drugs. Ann Allergy Asthma Immunol 2002, 89:542-550.
31. Gyllfors P, Bochenek G, Overholt J, et al.: Biochemical and clinical evidence that aspirin-intolerant asthmatic subjects tolerate the cyclooxygenase 2-selective analgetic drug celecoxib. J Allergy Clin Immunol 2003, 111:1116-1121. This double-blind, placebo-controlled trial of 33 subjects with typical histories of AIA and confirmed intolerance to aspirin showed that all subjects tolerated acute exposure to celecoxib. This was documented with regard to pulmonary and extra-pulmonary symptoms as well as measurements of biochemical markers of AIA.
32. Bochenek G, Nagraba K, Nizankowska E, et al.: A controlled study of 9alpha,11beta-PGF2 (a prostaglandin D2 metabolite) in plasma and urine of patients with bronchial asthma and healthy controls after aspirin challenge. J Allergy Clin Immunol 2003, 111:743-749.
33. Pierzchalska M, Szabo Z, Sanak M, et al.: Deficient prostaglandin E2 production by bronchial fibroblasts of asthmatic patients, with special reference to aspirin-induced asthma. J Allergy Clin Immunol 2003, 111:1041-1048.
34. Antczak A, Montuschi P, Kharitonov S, et al.: Increased exhaled cysteinyl-leukotrienes and 8-isoprostane in aspirin-induced asthma. Am J Respir Crit Care Med 2002, 166:301-306. Cys-LTs, PGE2, LTB4, and 8-isoprostane were measured in exhaled breath condensate from 31 patients with AIA, 26 aspirin-tolerant asthmatics, and 16 healthy subjects. Cys-LTs and 8-isoprostane levels were elevated in steroid-naive AIA patients and aspirin-tolerant patients. Steroid treatment led to a decrease in these compounds in patients with AIA but not in aspirin-tolerant patients. LTB4 and PGE2 levels were not increased in either group.
35. Picado C, Bioque G, Roca-Ferrer J, et al.: Nuclear factor-kappaB activity is down-regulated in nasal polyps from aspirin-sensitive asthmatics. Allergy 2003, 58:122-126.
36. Hahn DL: Chlamydia pneumoniae and the "Dutch Hypothesis." Chest 2002, 122:1510-1512.
37. Lemanske RF Jr: Is asthma an infectious disease? Chest 2003, 123(suppl 3):385S-390S.
38. Hahn DL, Dodge RW, Golubjatnikov R: Association of Chlamydia pneumoniae (strain TWAR) infection with wheezing, asthmatic bronchitis, and adult-onset asthma. JAMA 1991, 266:225-230.
39. Falck G, Gnarpe J, Hansson LO, et al.: Comparison of individuals with and without specific IgA antibodies to Chlamydia pneumoniae: respiratory morbidity and the metabolic syndrome. Chest 2002, 122:1587-1593.
40. Betsou F, Borrego MJ, Guillaume N, et al.: Cross-reactivity between Chlamydia trachomatis heat shock protein 10 and early pregnancy factor. Clin Diagn Lab Immunol 2003, 10:446-450.
41. Karjalainen A, Kurppa K, Martikainen R, et al.: Work is related to a substantial portion of adult-onset asthma incidence in the Finnish population. Am J Respir Crit Care Med 2001, 164:565-568.
42. Chan-Yeung M, Malo JL, Tarlo SM, et al.: Proceedings of the first Jack Pepys Occupational Asthma Symposium. Am J Respir Crit Care Med 2003, 167:450-471. This workshop report provides state-of-the-art current scientific knowledge about occupational asthma and reactive airways disease.
43. Balmes J, Becklake M, Blanc P, et al.: American Thoracic Society statement: occupational contribution to the burden of airway disease. Am J Respir Crit Care Med 2003, 167:787-797.
44. Frew AJ: Advances in environmental and occupational disorders. J Allergy Clin Immunol 2003, 111 (suppl 3):S824-S828.
45. Bardana EJ Jr: Occupational asthma and allergies. J Allergy Clin Immunol 2003, 111(suppl 2):S530-S539.
46. Vandenplas O, Malo JL: Definitions and types of work-related asthma: a nosological approach. Eur Respir J 2003, 21:706-712.
47. De Meer G, Postma DS, Heederik D: Bronchial responsiveness to adenosine 5′-monophosphate and methacholine as predictors for nasal symptoms due to newly introduced allergens. A follow-up study among laboratory animal workers and bakery apprentices. Clin Exp Allergy 2003, 33:789-794. This 1-year follow-up study of 118 newly employed bakery apprentices and laboratory animal workers showed that new-onset nasal symptoms were predicted by specific allergen sensitization and bronchial responsiveness to adenosine 5′-monophosphate.
48. Jeal H, Draper A, Jones M, et al.: HLA associations with occupational sensitization to rat lipocalin allergens: a model for other animal allergies? J Allergy Clin Immunol 2003, 111:795-799.
49. Newman-Taylor AJ: HLA phenotype and exposure in development of occupational asthma. Ann Allergy Asthma Immunol 2003, 90:24-27.
50. Mapp CE, Fryer AA, De Marzo N, et al.: Glutathione S-transferase GSTP1 is a susceptibility gene for occupational asthma induced by isocyanates. J Allergy Clin Immunol 2002, 109:867-872.
51. Wikman H, Piirila P, Rosenberg C, et al.: N-acetyltransferase genotypes as modifiers of diisocyanate exposure-associated asthma risk. Pharmacogenetics 2002, 12:227-233.
52. Liu Q, Wisnewski AV: Recent developments in diisocyanate asthma. Ann Allergy Asthma Immunol 2003, 90(5 suppl 2):35-41.
53. Tarlo SM: Workplace irritant exposures: do they produce true occupational asthma? Ann Allergy Asthma Immunol 2003, 90(5 suppl 2):19-23.
54. Prezant DJ, Weiden M, Banauch GI, et al.: Cough and bronchial responsiveness in firelighters at the World Trade Center site. N Engl J Med 2002, 347:806-815. Severe cough occurred in 332 of 9914 firelighters after the collapse of the World Trade Center. Sixty-three percent had a response to a bronchodilator and 24% had bronchial hyperresponsiveness 6 months after the event. The development and persistence of hyperreactivity and reactive airways dysfunction were strongly and independently associated with exposure intensity.
55. Martin JG, Campbell HR, Iijima H, et al. Chlorine-induced injury to the airways in the mouse. Am J Respir Crit Care Med 2003, 168:568-574. In an A/J mouse model, a 5-minute exposure to chlorine caused oxidative injury to the airways with epithelial loss and an increase in airway responsiveness to methacholine 24 hours after exposure. Inducible nitric oxide synthase was involved in the induction of changes in responsiveness to methacholine.
56. Thickett KM, McCoach JS, Gerber JM, et al.: Occupational asthma caused by chloramines in indoor swimming-pool air. Eur Respir J 2002, 19:827-832.
57. Wenzel SE, Schwartz LB, Langmack EL, et al.: Evidence that severe asthma can be divided pathologically into two inflammatory subtypes with distinct physiologic and clinical characteristics. Am J Respir Crit Care Med 1999, 160:1001-1008.
58. Douwes J, Gibson P, Pekkanen J, et al.: Non-eosinophilic asthma: importance and possible mechanisms. Thorax 2002, 57:643-648.
59. Green RH, Brightling CE, Weltmann G, et al.: Analysis of induced sputum in adults with asthma: identification of subgroup with isolated sputum neutrophilia and poor response to inhaled corticosteroids. Thorax 2002, 57:875-879. Sputum specimens were obtained from 259 adults with asthma and 34 control subjects using hypertonic saline challenge. A subgroup (23% of patients) had a sputum cell profile with increased neutrophils without eosinophils. Patients with isolated sputum neutrophilia responded less well to inhaled corticosteroids than the other subjects.
60. Wenzel S: Severe/fatal asthma. Chest 2003, 123(suppl 3):405S-410S.
61. Castro M: Near-fatal asthma: what have we learned? Chest 2002, 121:1394-1395.
62. Jorgensen IM, Bulow S, Jensen VB, et al.: Asthma mortality in Danish children and young adults, 1973-1994: epidemiology and validity of death certificates. Eur Respir J 2000, 15:844-848.
63. Mitchell I, Tough SC, Semple LK, et al.: Near-fatal asthma: a population-based study of risk factors. Chest 2002, 121:1407-1413.
64. Morahan G, Huang D, Wu M, et al.: Association of IL12B promoter polymorphism with severity of atopic and non-atopic asthma in children. Lancet 2002, 360:455-459.
65. Yao TC, Kuo ML, See LC, et al.: The RANTES promoter polymorphism: a genetic risk factor for near-fatal asthma in Chinese children. J Allergy Clin Immunol 2003, 111;1285-1292.
66. Konig P: Irreversible airway obstruction in childhood asthma? A clinician's viewpoint. Pediatr Pulmonol 2002, 33:307-310.
67. Vonk JM, Jongepier H, Panhuysen CI, et al.: Risk factors associated with the presence of irreversible airflow limitation and reduced transfer coefficient in patients with asthma after 26 years of follow up. Thorax 2003, 58:322-327.
68. Vignola AM, Mirabella F, Costanzo G, et al.: Airway remodeling in asthma. Chest 2003, 123(suppl 3):417S-422S.
69. Lange P, Parner J, Vestbo J, et al.: A 15-year follow-up study of ventilatory function in adults with asthma. N Engl J Med 1998, 339:1194-1200.
70. ten Brinke A, van Dissel JT, Sterk PJ, et al.: Persistent airflow limitation in adult-onset nonatopic asthma is associated with serologic evidence of Chlamydia pneumoniae infection. J Allergy Clin Immunol 2001, 107:449-454.
71. Fabbri LM, Romagnoli M, Corbetta L, et al.: Differences in airway inflammation in patients with fixed airflow obstruction due to asthma or chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2003, 167:418-424. Markers of airway inflammation in peripheral blood, sputum, and mucosal biopsies were compared between 27 subjects with a history of chronic obstructive pulmonary disease and 19 subjects with a history of asthma with a similar degree of fixed airway obstruction. The results show that the two groups of patients exhibit a different pattern of airway inflammation, suggesting that the type of airway inflammation in asthma does not change with the development of fixed airflow obstruction.
72. Benayoun L, Druilhe A, Dombret MC, et al.: Airway structural alterations selectively associated with severe asthma. Am J Respir Crit Care Med 2003, 167:1360-1368. Airway mucosal biopsies were analyzed in 40 patients with asthma of different severity, in 10 patients with chronic obstructive pulmonary disease, and in 10 healthy control subjects. Multivariate analysis of the data showed that airway smooth muscle hypertrophy and fibroblast accumulation, but not epithelial damage, granulocyte infiltration, or thickness of subbasement membrane were selectively associated with severe persistent asthma.
73. Lewis CC, Chu HW, Westcott JY, et al.: Increased expression of platelet-derived growth factor receptor-beta in airway fibroblasts of severe asthmatics. Chest 2003, 123(suppl 3):428S-429S.
74. 1 antagonist montelukast. This might be an important mechanism involved in airway remodeling in asthma.
75. Davies DE, Wicks J, Powell RM, et al.: Airway remodeling in asthma: new insights. J Allergy Clin lmmunol 2003, 111:215-225. This paper describes a challenging alternative view of asthma pathogenesis and remodeling by emphasizing the importance of the epithelial mesenchymal trophic unit.
76. Leung DY, Bloom JW: Update on glucocorticoid action and resistance. J Allergy Clin Immunol 2003, 111:3-22. This is an extensive and very useful review on the mechanisms of glucocorticoid action and resistance, including an algorithm for management of glucocorticoid-resistant asthma.