Clinical Differences between Early- and Late-Onset Asthma: A Population-Based Cross-Sectional Study

Background. Limited information exists about the nature of late-onset asthma (LOA) without medication intervention when compared to early-onset asthma (EOA). Our goal was to understand how EOA and LOA affect clinical and pathophysiological features. Methods. A population-based cross-sectional study...

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Main Authors: Jiaming Li, Ling Ye, Jun She, Yuanlin Song
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Canadian Respiratory Journal
Online Access:http://dx.doi.org/10.1155/2021/8886520
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author Jiaming Li
Ling Ye
Jun She
Yuanlin Song
author_facet Jiaming Li
Ling Ye
Jun She
Yuanlin Song
author_sort Jiaming Li
collection DOAJ
description Background. Limited information exists about the nature of late-onset asthma (LOA) without medication intervention when compared to early-onset asthma (EOA). Our goal was to understand how EOA and LOA affect clinical and pathophysiological features. Methods. A population-based cross-sectional study was carried out in Zhongshan Hospital (Shanghai, China). EOA and LOA were based on age of diagnosis (before and after age 40 years, respectively). Clinical variables were collected with an emphasis on allergic features, analyzed, related, and compared using one-way ANOVA or Kruskal-Wallis test. Correlations between blood basophils and clinical data were evaluated by Spearman’s rank test. Statistical analyses were conducted with SPSS v24.0. Results. Of a total of 12,760 adults with cough, sputum, or chest tightness, 90 subjects with EOA (mean age ± standard deviation (SD):28.73 ± 5.89), 111 with LOA (mean age ± SD: 60.25 ± 9.85), and 106 with chronic obstructive pulmonary disease (COPD) (mean age ± SD: 61.58 ± 10.95) were selected. FEV1/FVC (%), FEV1% predicted, and FVC% predicted were all significantly lower in LOA compared to EOA p<0.01. The values of post-bronchodilator FEV1 in bronchodilator reversibility testing were higher in the LOA and EOA groups compared to subjects with COPD p<0.01. Among allergic features, mite sensitization was most common in EOA patients, followed by LOA and COPD, whereas mold sensitization was more prevalent in LOA than EOA. Moreover, blood eosinophils were a typical feature of asthma in both EOA and LOA compared to COPD and controls p<0.01, and there were no differences in blood neutrophils in LOA compared to controls. Interestingly, blood basophils were increased in both EOA p<0.01 and LOA p<0.05 compared to COPD and controls. This variable correlated with eosinophils in EOA (r = 0.549, p=0.002) but not in LOA. Conclusion. LOA is a distinct clinical entity from EOA. In LOA, atopy was less frequent and spirometry values were lower when compared to EOA. In EOA, blood basophils and eosinophils were significantly correlated owing to pathophysiological differences between the two forms of the disease.
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spelling doaj-art-2fffd7c922724df7b240845efe2423992025-08-20T02:07:56ZengWileyCanadian Respiratory Journal1198-22411916-72452021-01-01202110.1155/2021/88865208886520Clinical Differences between Early- and Late-Onset Asthma: A Population-Based Cross-Sectional StudyJiaming Li0Ling Ye1Jun She2Yuanlin Song3Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaBackground. Limited information exists about the nature of late-onset asthma (LOA) without medication intervention when compared to early-onset asthma (EOA). Our goal was to understand how EOA and LOA affect clinical and pathophysiological features. Methods. A population-based cross-sectional study was carried out in Zhongshan Hospital (Shanghai, China). EOA and LOA were based on age of diagnosis (before and after age 40 years, respectively). Clinical variables were collected with an emphasis on allergic features, analyzed, related, and compared using one-way ANOVA or Kruskal-Wallis test. Correlations between blood basophils and clinical data were evaluated by Spearman’s rank test. Statistical analyses were conducted with SPSS v24.0. Results. Of a total of 12,760 adults with cough, sputum, or chest tightness, 90 subjects with EOA (mean age ± standard deviation (SD):28.73 ± 5.89), 111 with LOA (mean age ± SD: 60.25 ± 9.85), and 106 with chronic obstructive pulmonary disease (COPD) (mean age ± SD: 61.58 ± 10.95) were selected. FEV1/FVC (%), FEV1% predicted, and FVC% predicted were all significantly lower in LOA compared to EOA p<0.01. The values of post-bronchodilator FEV1 in bronchodilator reversibility testing were higher in the LOA and EOA groups compared to subjects with COPD p<0.01. Among allergic features, mite sensitization was most common in EOA patients, followed by LOA and COPD, whereas mold sensitization was more prevalent in LOA than EOA. Moreover, blood eosinophils were a typical feature of asthma in both EOA and LOA compared to COPD and controls p<0.01, and there were no differences in blood neutrophils in LOA compared to controls. Interestingly, blood basophils were increased in both EOA p<0.01 and LOA p<0.05 compared to COPD and controls. This variable correlated with eosinophils in EOA (r = 0.549, p=0.002) but not in LOA. Conclusion. LOA is a distinct clinical entity from EOA. In LOA, atopy was less frequent and spirometry values were lower when compared to EOA. In EOA, blood basophils and eosinophils were significantly correlated owing to pathophysiological differences between the two forms of the disease.http://dx.doi.org/10.1155/2021/8886520
spellingShingle Jiaming Li
Ling Ye
Jun She
Yuanlin Song
Clinical Differences between Early- and Late-Onset Asthma: A Population-Based Cross-Sectional Study
Canadian Respiratory Journal
title Clinical Differences between Early- and Late-Onset Asthma: A Population-Based Cross-Sectional Study
title_full Clinical Differences between Early- and Late-Onset Asthma: A Population-Based Cross-Sectional Study
title_fullStr Clinical Differences between Early- and Late-Onset Asthma: A Population-Based Cross-Sectional Study
title_full_unstemmed Clinical Differences between Early- and Late-Onset Asthma: A Population-Based Cross-Sectional Study
title_short Clinical Differences between Early- and Late-Onset Asthma: A Population-Based Cross-Sectional Study
title_sort clinical differences between early and late onset asthma a population based cross sectional study
url http://dx.doi.org/10.1155/2021/8886520
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