Marina Gueçamburu, Axelle Dupont, Bernice Djidonou, Charlotte Thibaut de Ménonville, Leyla Barakat, Félix Laborier, Mathilde Le Brun, Clairelyne Dupin, Catherine Neukirch, Camille Taillé
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引用次数: 0
Abstract
Aim: The impact of sensitization on asthma outcomes in adults is still being discussed. This study aims to describe the sensitization profiles and allergic comorbidities of patients with severe asthma, and to analyze their association with asthma severity.
Patients and methods: This retrospective study included adult patients, evaluated at the Severe Asthma Clinic of Bichat University Hospital (Paris, France) during a 1-day hospital stay between May 2022 and January 2024. Sensitization, defined by a positive skin prick test and/or allergen-specific IgE levels greater than 0.10 kUA/L, was analysed alongside allergic comorbidities. The ASSESS score was used to grade asthma severity.
Results: Of the 201 patients included, 142 (70.6%) exhibited at least one sensitization to an aeroallergen, of whom 38 (26.8%) were monosensitized, and 104 (73.2%) were polysensitized. Compared to polysensitized patients, monosensitized patients were older at diagnosis (years: 30.6 ± 20.1 vs 21.7 ± 17.6, p = 0.01), had a higher ASSESS score (median (Q1; Q3); 13 (11; 15) vs 11 (9; 14), p = 0.02), a lower pre-bronchodilator forced expiratory volume in 1 second (%pred: 70.3 ± 23.2 vs 79.3 ± 21.8, p = 0.03), and experienced a greater burden of exacerbations (p = 0.03). There were significantly more polysensitized patients with at least three allergic comorbidities, but the number of allergic comorbidities did not correlate with asthma severity.
Conclusion: Monosensitized patients exhibited more severe disease and greater airway obstruction compared to polysensitized individuals. These findings suggest that allergies, especially in cases of late-onset asthma, may not be a significant determinant of asthma severity in adults.
目的：致敏对成人哮喘结局的影响仍在讨论中。本研究旨在描述严重哮喘患者的致敏特征和过敏合并症，并分析其与哮喘严重程度的关系。患者和方法：本回顾性研究纳入成年患者，于2022年5月至2024年1月期间在比夏大学医院（法国巴黎）重症哮喘诊所住院1天。致敏，定义为皮肤点刺试验阳性和/或过敏原特异性IgE水平大于0.10 kUA/L，与过敏合并症一起分析。评估评分用于哮喘严重程度分级。结果：纳入的201例患者中，142例（70.6%）表现出至少一种空气过敏原致敏，其中38例（26.8%）为单致敏，104例（73.2%）为多致敏。与多致敏患者相比，单致敏患者在诊断时年龄更大（年龄：30.6±20.1 vs 21.7±17.6,p = 0.01），评估评分更高(中位数(Q1；第三季度);13 (11;15) vs 11 (9)；14), p = 0.02)，使用支气管扩张剂前1秒用力呼气量较低（%pred: 70.3±23.2 vs 79.3±21.8,p = 0.03），并且加重了加重负担（p = 0.03）。具有至少三种过敏性合并症的多致敏患者明显更多，但过敏性合并症的数量与哮喘严重程度无关。结论：与多致敏个体相比，单致敏患者表现出更严重的疾病和更大的气道阻塞。这些发现表明，过敏，特别是在迟发性哮喘的情况下，可能不是成人哮喘严重程度的重要决定因素。
期刊介绍：
An international, peer-reviewed journal publishing original research, reports, editorials and commentaries on the following topics: Asthma; Pulmonary physiology; Asthma related clinical health; Clinical immunology and the immunological basis of disease; Pharmacological interventions and new therapies.
Although the main focus of the journal will be to publish research and clinical results in humans, preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies.
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