Asthma similarities across ProAR (Brazil) and U-BIOPRED (Europe) adult cohorts of contrasting locations, ethnicity and socioeconomic status
Asthma similarities across ProAR (Brazil) and U-BIOPRED (Europe) adult cohorts of contrasting locations, ethnicity and socioeconomic status
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DOI：
10.1016/j.rmed.2019.105817
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发表时间：
2020-01-01
影响因子：
4.3
通讯作者：
Chung, Kian Fan
中科院分区：
文献类型：
--
作者：
Cruz, Alvaro A.;Riley, John H.;Chung, Kian Fan
背景：全球哮喘患病率为3.39亿。“严重哮喘”（SA）包括受试者与不受控制的哮喘，尽管适当的management.Objectives：比较哮喘从不同的种族和environments.Methods：两个成人队列，巴西（ProAR）和欧洲（U-BIOPRED）的横断面分析。U-BIOPRED包括311名患有重度哮喘（SAn）的非吸烟者，110名患有SA（SAs）的吸烟者或戒烟者以及88名轻度至中度哮喘患者（MMA），而ProAR包括544名SA和452名MMA。虽然这些项目是独立的，但在目的和方法上有相似之处，ProAR采用U-BIOPRED的操作程序。结果：SA受试者中，年龄、体重、既往吸烟者比例和使用支气管扩张剂前的FEV 1相似。两组变应原皮肤点刺试验（SPT）阳性的SA比例、鼻腔鼻窦症状评分及生活质量评分均相当。此外，血液嗜酸性粒细胞计数（EOS）和EOS > 300个细胞/μ l的受试者百分比没有差异。然而，患有SA的欧洲人更严重，持续口服皮质类固醇（OCS）的比例更大，症状更严重，加重更频繁。欧洲人使用支气管扩张剂前后的FEV 1/FVC较低。结论：ProAR和U-BIOPRED队列在不同严重程度、种族和环境方面具有相似性，为全球哮喘表型的外部验证提供了依据。这将促进哮喘协会之间的合作，目的是了解SA，这将导致更好的管理。
Background: Asthma prevalence is 339 million globally. 'Severe asthma' (SA) comprises subjects with uncontrolled asthma despite proper management.Objectives: To compare asthma from diverse ethnicities and environments.Methods: A cross-sectional analysis of two adult cohorts, a Brazilian (ProAR) and a European (U-BIOPRED). U-BIOPRED comprised of 311 non-smoking with Severe Asthma (SAn), 110 smokers or ex-smokers with SA (SAs) and 88 mild to moderate asthmatics (MMA) while ProAR included 544 SA and 452 MMA. Although these projects were independent, there were similarities in objectives and methodology, with ProAR adopting operating procedures of U-BIOPRED.Results: Among SA subjects, age, weight, proportion of former smokers and FEV1 pre-bronchodilator were similar. The proportion of SA with a positive skin prick tests (SPT) to aeroallergens, the scores of sino-nasal symptoms and quality of life were comparable. In addition, blood eosinophil counts (EOS) and the % of subjects with EOS > 300 cells/mu l were not different. The Europeans with SA however, were more severe with a greater proportion of continuous oral corticosteroids (OCS), worse symptoms and more frequent exacerbations. FEV1/FVC pre- and post-bronchodilator were lower among the Europeans. The MMA cohorts were less comparable in control and treatment, but similar in the proportion of allergic rhinitis, gastroesophageal reflux disease and EOS >3%.Conclusions: ProAR and U-BIOPRED cohorts, with varying severity, ethnicity and environment have similarities, which provide the basis for global external validation of asthma phenotypes. This should stimulate collaboration between asthma consortia with the aim of understanding SA, which will lead to better management.