Severity of adult-onset asthma : a matter of blood neutrophils and severe obesity
Background: Adult-onset asthma is associated with a poor treatment response. The aim was to study associations between clinical characteristics, asthma control and treatment in adult-onset asthma. Methods: Previous participants within the population-based Obstructive Lung Disease in Northern Sweden...
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Umeå universitet, Avdelningen för hållbar hälsa
2023
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Online Access: | http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-215097 https://doi.org/10.1016/j.rmed.2023.107418 |
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ftumeauniv:oai:DiVA.org:umu-215097 2023-11-12T04:23:24+01:00 Severity of adult-onset asthma : a matter of blood neutrophils and severe obesity Winsa-Lindmark, Sofia Stridsman, Caroline Sahlin, Axel Hedman, Linnea Stenfors, Nikolai Myrberg, Tomi Lindberg, Anne Rönmark, Eva Backman, Helena 2023 application/pdf http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-215097 https://doi.org/10.1016/j.rmed.2023.107418 eng eng Umeå universitet, Avdelningen för hållbar hälsa Umeå universitet, Institutionen för folkhälsa och klinisk medicin Umeå universitet, Institutionen för kirurgisk och perioperativ vetenskap Respiratory Medicine, 0954-6111, 2023, 219, orcid:0000-0001-6622-3838 orcid:0000-0002-1630-3167 orcid:0000-0002-1684-1301 orcid:0000-0002-3292-7471 orcid:0000-0002-2358-8754 orcid:0000-0002-0553-8067 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-215097 doi:10.1016/j.rmed.2023.107418 Scopus 2-s2.0-85172762762 info:eu-repo/semantics/openAccess Body mass index Eosinophils Epidemiology Follow-up studies Neutrophils Sweden Respiratory Medicine and Allergy Lungmedicin och allergi Article in journal info:eu-repo/semantics/article text 2023 ftumeauniv https://doi.org/10.1016/j.rmed.2023.107418 2023-10-18T22:36:25Z Background: Adult-onset asthma is associated with a poor treatment response. The aim was to study associations between clinical characteristics, asthma control and treatment in adult-onset asthma. Methods: Previous participants within the population-based Obstructive Lung Disease in Northern Sweden studies (OLIN) were in 2019–2020 invited to clinical examinations including structured interviews, spirometry, fractional exhaled nitric oxide (FeNO), skin prick test and blood sampling. In total, n = 251 individuals with adult-onset asthma (debut >15 years of age) were identified. Uncontrolled asthma was defined according to ERS/ATS and treatment step according to GINA (2019). Results: Among individuals with uncontrolled asthma (34%), severe obesity (16.3% vs 7.9%, p = 0.041) and elevated levels of blood neutrophils, both regarding mean level of blood neutrophils (4.25*109/L vs 3.67*109/L, p = 0.003), and proportions with ≥4*109/L (49.4% vs 33.3%, p = 0.017) and ≥5*109/L (32.1% vs 13.7%, p < 0.001) were more common than among those with controlled asthma. Adding the dimension of GINA treatment step 1–5, individuals with uncontrolled asthma on step 4–5 treatment had the highest proportions of blood neutrophils ≥5*109/L (45.5%), severe obesity (BMI≥35, 26.1%), dyspnea (mMRC≥2) (34.8%), and most impaired lung function in terms of FEV1%<80% of predicted (42.9%), FEV1<LLN (47.6%), FVC<80% of predicted (42.9%) and FVC < LLN (38.1%). No associations between level of asthma control and treatment were found regarding blood eosinophils, FeNO or allergic sensitization. Conclusion: This study indicates that in adult-onset asthma, primarily non-type-2 characteristics such as obesity and blood neutrophils associate with poor asthma control and higher doses of inhaled corticosteroids. Article in Journal/Newspaper Northern Sweden Umeå University: Publications (DiVA) Respiratory Medicine 219 107418 |
institution |
Open Polar |
collection |
Umeå University: Publications (DiVA) |
op_collection_id |
ftumeauniv |
language |
English |
topic |
Body mass index Eosinophils Epidemiology Follow-up studies Neutrophils Sweden Respiratory Medicine and Allergy Lungmedicin och allergi |
spellingShingle |
Body mass index Eosinophils Epidemiology Follow-up studies Neutrophils Sweden Respiratory Medicine and Allergy Lungmedicin och allergi Winsa-Lindmark, Sofia Stridsman, Caroline Sahlin, Axel Hedman, Linnea Stenfors, Nikolai Myrberg, Tomi Lindberg, Anne Rönmark, Eva Backman, Helena Severity of adult-onset asthma : a matter of blood neutrophils and severe obesity |
topic_facet |
Body mass index Eosinophils Epidemiology Follow-up studies Neutrophils Sweden Respiratory Medicine and Allergy Lungmedicin och allergi |
description |
Background: Adult-onset asthma is associated with a poor treatment response. The aim was to study associations between clinical characteristics, asthma control and treatment in adult-onset asthma. Methods: Previous participants within the population-based Obstructive Lung Disease in Northern Sweden studies (OLIN) were in 2019–2020 invited to clinical examinations including structured interviews, spirometry, fractional exhaled nitric oxide (FeNO), skin prick test and blood sampling. In total, n = 251 individuals with adult-onset asthma (debut >15 years of age) were identified. Uncontrolled asthma was defined according to ERS/ATS and treatment step according to GINA (2019). Results: Among individuals with uncontrolled asthma (34%), severe obesity (16.3% vs 7.9%, p = 0.041) and elevated levels of blood neutrophils, both regarding mean level of blood neutrophils (4.25*109/L vs 3.67*109/L, p = 0.003), and proportions with ≥4*109/L (49.4% vs 33.3%, p = 0.017) and ≥5*109/L (32.1% vs 13.7%, p < 0.001) were more common than among those with controlled asthma. Adding the dimension of GINA treatment step 1–5, individuals with uncontrolled asthma on step 4–5 treatment had the highest proportions of blood neutrophils ≥5*109/L (45.5%), severe obesity (BMI≥35, 26.1%), dyspnea (mMRC≥2) (34.8%), and most impaired lung function in terms of FEV1%<80% of predicted (42.9%), FEV1<LLN (47.6%), FVC<80% of predicted (42.9%) and FVC < LLN (38.1%). No associations between level of asthma control and treatment were found regarding blood eosinophils, FeNO or allergic sensitization. Conclusion: This study indicates that in adult-onset asthma, primarily non-type-2 characteristics such as obesity and blood neutrophils associate with poor asthma control and higher doses of inhaled corticosteroids. |
format |
Article in Journal/Newspaper |
author |
Winsa-Lindmark, Sofia Stridsman, Caroline Sahlin, Axel Hedman, Linnea Stenfors, Nikolai Myrberg, Tomi Lindberg, Anne Rönmark, Eva Backman, Helena |
author_facet |
Winsa-Lindmark, Sofia Stridsman, Caroline Sahlin, Axel Hedman, Linnea Stenfors, Nikolai Myrberg, Tomi Lindberg, Anne Rönmark, Eva Backman, Helena |
author_sort |
Winsa-Lindmark, Sofia |
title |
Severity of adult-onset asthma : a matter of blood neutrophils and severe obesity |
title_short |
Severity of adult-onset asthma : a matter of blood neutrophils and severe obesity |
title_full |
Severity of adult-onset asthma : a matter of blood neutrophils and severe obesity |
title_fullStr |
Severity of adult-onset asthma : a matter of blood neutrophils and severe obesity |
title_full_unstemmed |
Severity of adult-onset asthma : a matter of blood neutrophils and severe obesity |
title_sort |
severity of adult-onset asthma : a matter of blood neutrophils and severe obesity |
publisher |
Umeå universitet, Avdelningen för hållbar hälsa |
publishDate |
2023 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-215097 https://doi.org/10.1016/j.rmed.2023.107418 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_relation |
Respiratory Medicine, 0954-6111, 2023, 219, orcid:0000-0001-6622-3838 orcid:0000-0002-1630-3167 orcid:0000-0002-1684-1301 orcid:0000-0002-3292-7471 orcid:0000-0002-2358-8754 orcid:0000-0002-0553-8067 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-215097 doi:10.1016/j.rmed.2023.107418 Scopus 2-s2.0-85172762762 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.1016/j.rmed.2023.107418 |
container_title |
Respiratory Medicine |
container_volume |
219 |
container_start_page |
107418 |
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1782338185539354624 |