Clinical characteristics and possible phenotypes of an adult severe asthma population

Autor(es)

de Carvalho-Pinto, Regina Maria ^[1] ; Cukier, Alberto ^[1] ; Angelini, Luciene ^[1] ; Antonangelo, Leila ^[1] ; Mauad, Thais ^[2] ; Dolhnikoff, Marisa ^[2] ; Rabe, Klaus F. ^[3] ; Stelmach, Rafael ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Med, Dept Pulm, Heart Inst InCor, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Med, Dept Pathol, Sao Paulo - Brazil

^[3] Krankenhaus Grosshansdorf Zentrum Pneumol & Thora, Grosshansdorf - Germany

• Tipo de documento: Artigo Científico
• Fonte: RESPIRATORY MEDICINE; v. 106, n. 1, p. 47-56, JAN 2012.
• Citações Web of Science: 36

Resumo

Background: Currently, there are no studies of well-characterized severe asthmatics in Brazil. We aimed to study a population of severe treated asthmatics still uncontrolled to characterize them and define possible phenotypes. Methods: Descriptive cross-sectional outpatient study of severe asthmatics, evaluating functional and inflammatory markers, health-related quality of life, anxiety and depression symptoms, clinical control status, and characteristics related to atopy, age of asthma onset, induced sputum eosinophil levels, and airflow limitation. We also grouped the subgroups characteristics to identify phenotypes. The study is registered on ClinicalTrial.gov NCT 01089322. Results: From 128 eligible patients with severe/uncontrolled asthma, 74 fulfilled the inclusion criteria. The cohort was comprised of 85% women, frequently with a body mass index higher than 31 kg m(-2), atopy (60%), early-onset disease (50%), sputum eosinophilia (80%), comorbidities, and reduced quality of life. Nonatopics had significant higher asthma onset (19 y.a.) and twice level of induced sputum eosinophil. Late-onset patients had significantly less atopy (57%) and higher levels of induced sputum eosinophils. Non-eosinophilics had lower levels of inflammatory markers. Patients with airflow limitation had more intensive care unit admissions (56%) and 1.5 times more airway resistance. Subgroups characteristics identified a priori four well-characterized phenotypes, with 55% presenting sputum eosinophilia. Conclusion: Our data emphasize the high burden of disease, the persistence of inflammation and the existence of clinical possible phenotypes population sharing common features with published cohorts. Despite the necessity of further investigation into pathogenic mechanisms, this study with clinically difficult patient group may help to improve future asthma care. (C) 2011 Elsevier Ltd. All rights reserved. (AU)

• Processo FAPESP: 05/58757-3 - Fatores relacionados a dificuldade do controle da asma: avaliação sistemática e caracterização dos fatores histológicos ralacionados a resposta ao tratamento
• Beneficiário: Rafael Stelmach
• Linha de fomento: Auxílio à Pesquisa - Regular