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Journal of Allergy
Volume 2011 (2011), Article ID 843543, 7 pages
http://dx.doi.org/10.1155/2011/843543
Review Article

Asthma in the Elderly: Can We Distinguish It from COPD?

Department of Thoracic Medicine, University Hospital of Heraklion and Medical School, University of Crete, Heraklion 71110, Crete, Greece

Received 16 February 2011; Revised 23 April 2011; Accepted 6 May 2011

Academic Editor: Nicola Scichilone

Copyright © 2011 Eleni G. Tzortzaki et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. World Health Organization, Global Surveillance, Prevention and Control of Chronic Respiratory Diseases: A Comprehensive Approach, WHO Press, Geneva, Switzerland, 2007.
  2. J. A. Hardie, W. M. Vollmer, A. S. Buist, P. Bakke, and O. Morkve, “Respiratory symptoms and obstructive pulmonary disease in a population aged over 70 years,” Respiratory Medicine, vol. 99, no. 2, pp. 186–195, 2005. View at Publisher · View at Google Scholar · View at Scopus
  3. E. Murtagh, L. Heaney, J. Gingles, et al., “The prevalence of obstructive lung disease in a general population sample: the NICECOPD study,” European Journal of Epidemiology, vol. 20, no. 5, pp. 443–453, 2005. View at Publisher · View at Google Scholar · View at Scopus
  4. “Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA),” 2009, http://www.ginasthma.org/.
  5. National Asthma Education and Prevention Program (NAEPP), “Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma,” Full Report 2007, http://www.nhlbi.nih.gov/.
  6. P. G. Gibson, V. M. McDonald, and G. B. Marks, “Asthma in older adults,” The Lancet, vol. 376, no. 9743, pp. 803–813, 2010. View at Publisher · View at Google Scholar · View at Scopus
  7. V. Bellia, C. Pedone, F. Catalano, et al., “Asthma in the elderly: mortality rate and associated risk factors for mortality,” Chest, vol. 132, no. 4, pp. 1175–1182, 2007. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  8. E. Diaz-Guzman and D. M. Mannino, “Airway obstructive diseases in older adults: from detection to treatment,” Journal of Allergy and Clinical Immunology, vol. 126, no. 4, pp. 702–709, 2010. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  9. J. M. Vonk, H. Jongepier, C. I. M. Panhuysen, J. P. Schouten, E. R. Bleecker, and D. S. Postma, “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, vol. 58, no. 4, pp. 322–327, 2003. View at Publisher · View at Google Scholar · View at Scopus
  10. S. S. Braman, “Growing old with asthma: what are the changes and challenges?” Expert Review of Respiratory Medicine, vol. 4, no. 2, pp. 239–248, 2010. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  11. S. S. Braman and N. A. Hanania, “Asthma in older adults,” Clinics in Chest Medicine, vol. 28, no. 4, pp. 685–702, 2007. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  12. Global Initiative for Chronic Obstructive Lung Disease, “Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (GOLD),” 2010, http://www.goldcopd.com/.
  13. S. C. Jones, D. Iverson, P. Burns, U. Evers, P. Caputi, and S. Morgan, “Asthma and ageing: an end user's perspective—the perception and problems with the management of asthma in the elderly,” Clinical & Experimental Allergy, vol. 41, no. 4, pp. 471–481, 2011. View at Publisher · View at Google Scholar · View at PubMed
  14. E. Stupka and R. deShazo, “Asthma in seniors: part 1. Evidence for underdiagnosis, undertreatment, and increasing morbidity and mortality,” American Journal of Medicine, vol. 122, no. 1, pp. 6–11, 2009. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  15. P. Barua and M. S. O'Mahony, “Overcoming gaps in the management of asthma in older patients: new insights,” Drugs and Aging, vol. 22, no. 12, pp. 1029–1059, 2005. View at Publisher · View at Google Scholar · View at Scopus
  16. D. L. Urso, “Asthma in the elderly,” Current Gerontology and Geriatrics Research, vol. 2009, Article ID 858415, 5 pages, 2009. View at Scopus
  17. R. Pellegrino, G. Viegi, V. Brusasco, et al., “Interpretative strategies for lung function tests,” European Respiratory Journal, vol. 26, no. 5, pp. 948–968, 2005. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  18. D. P. Tashkin, B. Celli, M. Decramer, et al., “Bronchodilator responsiveness in patients with COPD,” European Respiratory Journal, vol. 31, no. 4, pp. 742–750, 2008. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  19. L. M. Fabbri, M. Romagnoli, L. Corbetta, et al., “Differences in airway inflammation in patients with fixed airflow obstruction due to asthma or chronic obstructive pulmonary disease,” American Journal of Respiratory and Critical Care Medicine, vol. 167, no. 3, pp. 418–424, 2003. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  20. D. L. Urso, D. Vincenzo, F. Pignataro, P. Acri, and G. Cucinotta, “Diagnosis and treatment of refractory asthma,” European Review for Medical and Pharmacological Sciences, vol. 12, no. 5, pp. 315–320, 2008. View at Scopus
  21. B. A. Sin, O. Akkoca, S. Saryal, F. Oner, and Z. Misirligil, “Differences between asthma and COPD in the elderly,” Journal of Investigational Allergology and Clinical Immunology, vol. 16, no. 1, pp. 44–50, 2006. View at Scopus
  22. S. T. Weiss, “Lung function and airway diseases,” Nature Genetics, vol. 42, no. 1, pp. 14–16, 2010. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  23. N. Scichilone, M. Messina, S. Battaglia, F. Catalano, and V. Bellia, “Airway hyperresponsiveness in the elderly: prevalence and clinical implications,” European Respiratory Journal, vol. 25, no. 2, pp. 364–375, 2005. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  24. N. Scichilone, A. Callari, G. Augugliaro, M. Marchese, A. Togias, and V. Bellia, “The impact of age on prevalence of positive skin prick tests and specific IgE tests,” Respiratory Medicine, vol. 105, no. 5, pp. 651–658, 2011. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  25. G. Cuttitta, F. Cibella, V. Bellia, et al., “Changes in FVC during methacholine-induced bronchoconstriction in elderly patients with asthma: bronchial hyperresponsiveness and aging,” Chest, vol. 119, no. 6, pp. 1685–1690, 2001. View at Publisher · View at Google Scholar · View at Scopus
  26. R. E. Kanner, J. E. Connett, M. D. Altose, et al., “Gender difference in airway hyperresponsiveness in smokers with mild COPD. The lung health study,” American Journal of Respiratory and Critical Care Medicine, vol. 150, no. 4, pp. 956–961, 1994. View at Scopus
  27. S. S. Török and J. D. Leuppi, “Bronchial hyper-responsiveness and exhaled nitric oxide in chronic obstructive pulmonary disease,” Swiss Medical Weekly, vol. 137, no. 27-28, pp. 385–391, 2007. View at Scopus
  28. R. Olivenstein and Q. Hamid, “Asthma in the elderly … Their time is right now,” Clinical and Experimental Allergy, vol. 41, no. 4, pp. 457–458, 2011. View at Publisher · View at Google Scholar · View at PubMed
  29. G. Sharma and J. Goodwin, “Effect of aging on respiratory system physiology and immunology,” Clinical Interventions in Aging, vol. 1, no. 3, pp. 253–260, 2006. View at Publisher · View at Google Scholar
  30. P. J. Busse and S. K. Mathur, “Age-related changes in immune function: effect on airway inflammation,” Journal of Allergy and Clinical Immunology, vol. 126, no. 4, pp. 690–699, 2010. View at Publisher · View at Google Scholar · View at PubMed
  31. N. B. Pride, “Pulmonary physiology,” in Asthma and COPD: Basic Mechanisms and Clinical Management, P. J. Barnes, J. M. Drazen, S. Rennard, and N. C. Thomson, Eds., pp. 43–56, Academic Press, San Diego, Calif, USA, 2002.
  32. J. C. Hogg, “Airway pathology,” in Asthma and COPD: Basic Mechanisms and Clinical Management, P. J. Barnes, J. M. Drazen, S. Rennard, and N. C. Thomson, Eds., pp. 57–67, Academic Press, San Diego, Calif, USA, 2002.
  33. P. K. Jeffery, “Remodeling in asthma and chronic obstructive lung disease,” American Journal of Respiratory and Critical Care Medicine, vol. 164, no. 10, pp. S28–S38, 2001. View at Scopus
  34. K. Aoshiba and A. Nagai, “Differences in airway remodeling between asthma and chronic obstructive pulmonary disease,” Clinical Reviews in Allergy and Immunology, vol. 27, no. 1, pp. 35–43, 2004. View at Scopus
  35. C. M. Sköld, “Remodeling in asthma and COPD—differences and similarities,” Clinical Respiratory Journal, vol. 4, supplement 1, pp. 20–27, 2010. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  36. Y. Nakano, N. L. Muller, G. G. King, et al., “Quantitative assessment of airway remodeling using high-resolution CT,” Chest, vol. 122, supplement 6, pp. 271S–275S, 2002. View at Scopus
  37. S. A. Little, M. W. Sproule, M. D. Cowan, et al., “High resolution computed tomographic assessment of airway wall thickness in chronic asthma: reproducibility and relationship with lung function and severity,” Thorax, vol. 57, no. 3, pp. 247–253, 2002. View at Publisher · View at Google Scholar · View at Scopus
  38. A. M. Vignola, F. Paganin, L. Capieu, et al., “Airway remodelling assessed by sputum and high-resolution computed tomography in asthma and COPD,” European Respiratory Journal, vol. 24, no. 6, pp. 910–917, 2004. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  39. S. Gupta, S. Siddiqui, P. Haldar, et al., “Quantitative analysis of high-resolution computed tomography scans in severe asthma subphenotypes,” Thorax, vol. 65, no. 9, pp. 775–781, 2010. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  40. A. D. Westont and L. Hood, “Systems biology, proteomics, and the future of health care: toward predictive, preventative, and personalized medicine,” Journal of Proteome Research, vol. 3, no. 2, pp. 179–196, 2004. View at Publisher · View at Google Scholar · View at Scopus
  41. N. Fens, A. H. Zwinderman, M. P. van der Schee, et al., “Exhaled breath profiling enables discrimination of chronic obstructive pulmonary disease and asthma,” American Journal of Respiratory and Critical Care Medicine, vol. 180, no. 11, pp. 1076–1082, 2009. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  42. G. P. Anderson and S. Bozinovski, “Acquired somatic mutations in the molecular pathogenesis of COPD,” Trends in Pharmacological Sciences, vol. 24, no. 2, pp. 71–76, 2003. View at Publisher · View at Google Scholar · View at Scopus
  43. N. M. Siafakas, E. G. Tzortzaki, G. Sourvinos, et al., “Microsatellite DNA instability in COPD,” Chest, vol. 116, no. 1, pp. 47–51, 1999. View at Publisher · View at Google Scholar · View at Scopus
  44. E. Paraskakis, G. Sourvinos, F. Passam, et al., “Microsatellite DNA instability and loss of heterozygosity in bronchial asthma,” European Respiratory Journal, vol. 22, no. 6, pp. 951–955, 2003. View at Scopus
  45. M. I. Zervou, E. G. Tzortzaki, D. Makris, et al., “Differences in microsatellite DNA level between asthma and chronic obstructive pulmonary disease,” European Respiratory Journal, vol. 28, no. 3, pp. 472–478, 2006. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  46. E. Dima, N. Rovina, C. Gerassimou, C. Roussos, and C. Gratziou, “Pulmonary function tests, sputum induction, and bronchial provocation tests: diagnostic tools in the challenge of distinguishing asthma and COPD phenotypes in clinical practice,” International Journal of Chronic Obstructive Pulmonary Disease, vol. 5, pp. 287–296, 2010.
  47. M. De Martinis, C. Franceschi, D. Monti, and L. Ginaldi, “Inflamm-ageing and lifelong antigenic load as major determinants of ageing rate and longevity,” FEBS Letters, vol. 579, no. 10, pp. 2035–2039, 2005. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  48. P. J. Busse and S. K. Mathur, “Age-related changes in immune function: effect on airway inflammation,” Journal of Allergy and Clinical Immunology, vol. 126, no. 4, pp. 690–699, 2010. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  49. Y. Jing, S. Gravenstein, N. R. Chaganty, et al., “Aging is associated with a rapid decline in frequency, alterations in subset composition, and enhanced Th2 response in CD1d-restricted NKT cells from human peripheral blood,” Experimental Gerontology, vol. 42, no. 8, pp. 719–732, 2007. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  50. K. A. Hwang, H. R. Kim, and I. Kang, “Aging and human CD4+ regulatory T cells,” Mechanisms of Ageing and Development, vol. 130, no. 8, pp. 509–517, 2009. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  51. G. Sharma, N. A. Hanania, and Y. M. Shim, “The aging immune system and its relationship to the development of chronic obstructive pulmonary disease,” Proceedings of the American Thoracic Society, vol. 6, no. 7, pp. 573–580, 2009. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  52. K. Ito and P. J. Barnes, “COPD as a disease of accelerated lung aging,” Chest, vol. 135, no. 1, pp. 173–180, 2009. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  53. C. Lambers, S. Hacker, M. Posch, et al., “T cell senescence and contraction of T cell repertoire diversity in patients with chronic obstructive pulmonary disease,” Clinical and Experimental Immunology, vol. 155, no. 3, pp. 466–475, 2009. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  54. K. Huss, P. L. Naumann, P. J. Mason, et al., “Asthma severity, atopic status, allergen exposure, and quality of life in elderly persons,” Annals of Allergy, Asthma and Immunology, vol. 86, no. 5, pp. 524–530, 2001. View at Publisher · View at Google Scholar · View at Scopus
  55. B. Sitkauskiene, R. Sakalauskas, K. Malakauskas, and J. Lotvall, “Reversibility to a b2-agonist in COPD: relationship to atopy and neutrophil activation,” Respiratory Medicine, vol. 97, no. 6, pp. 591–598, 2003. View at Publisher · View at Google Scholar · View at Scopus
  56. L. Rogers, C. Cassino, K. I. Berger, et al., “Asthma in the elderly: cockroach sensitization and severity of airway obstruction in elderly nonsmokers,” Chest, vol. 122, no. 5, pp. 1580–1586, 2002. View at Publisher · View at Google Scholar · View at Scopus