II. Epidemiology
- Much more common in adults than children
- Onset age over 40 years old
III. Pathophysiology
- Non-IgE, Non-allergic Asthma
- Neutrophil mediated Asthma
IV. Types: Phenotypes
- Neutrophilic Asthma (adult onset, non-atopic)
- May be paucigranulocytic or Neutrophilic
- Biomarkers include NLRP3/IL-1b and Th17, MMP-9
-
Obesity Associated (esp. female)
- Mediators include oxidative stress, Neutrophil activity, activation of Innate Immunity
- Biomarkers include Serum IL-6
- Associated with severe symptoms despite preserved lung function
- Smoking Associated
- Typically occurs in older adults, with frequent exacerbations and reduced lung function testing
- Differentiate from COPD (or both may be present)
- Induced Sputum with increased Neutrophils (see labs below)
- Mediators include oxidative stress as well as mixed Th2 high and Th2 low activity
- Very Late Onset Asthma (age >50 or >65 years)
- Often steroid resistant
- Induced Sputum with increased Neutrophils (see labs below)
- Mediators include immunosenescence and Th1/Th7 inflammation
V. Risk Factors
- Irritant exposure (esp. Tobacco Smoking)
- Air Pollution
- Fumes
- Perfumes
- Household cleaning agents
- Insecticides
- Fresh paint
- Tobacco Smoking or Secondhand Smoke
- Cold air
- Infection
- Gastroesophageal Reflux
- Medications
- Beta Blockers (even Intraocular Beta Blocker)
- Body Habitus
VI. Findings: Symptoms and Signs
VII. Labs: Markers
-
Neutrophilia
- Sputum Neutrophils >40 to 60%
-
Cytokines (experimental)
- Interleukins (IL-6, IL-8, IL-17)
- Adipokine (Obesity)
VIII. Management
- See Asthma Management
- See Asthma Exacerbation
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 493.1 |
| ICD10 | J45.1 , J45 |
| SnomedCT | 266397004, 8312004, 195973000, 195976008, 155576005, 266361008 |
| English | Intrinsic asthma NOS, Nonallergic asthma, Intrinsic asthma, intrinsic asthma, intrinsic asthma (diagnosis), asthma intrinsic, asthma nonallergic, intrinsic nonallergic asthma, nonallergic asthma, Intrinsic asthma (disorder), Intrinsic asthma NOS (disorder), Non-allergic asthma (diagnosis), asthma non-allergic, Asthma due to internal immunological process, Non-allergic asthma, Non-allergic asthma (disorder), asthma; intrinsic, nonallergic, asthma; intrinsic, asthma; nonallergic, intrinsic; asthma, nonallergic, intrinsic; asthma, nonallergic; asthma, Intrinsic asthma (disorder) [Ambiguous] |
| Spanish | asma intrínseca, asma no alérgica (trastorno), asma no alérgica, Asma intrínseca, asma intrínseco, SAI (trastorno), asma no alérgico, asma intrínseco, SAI, asma no alérgico (trastorno), asma intrínseco, asma intrínseca (trastorno), asma intrínseca, SAI, asma intrínseca, SAI (trastorno), asma por proceso inmunológico interno, asma intrínseca (concepto no activo) |
| Dutch | intrinsiek astma, astma; intrinsiek, niet allergisch, astma; intrinsiek, astma; niet-allergisch, intrinsiek; astma, niet allergisch, intrinsiek; astma, niet-allergisch; astma, Niet-allergisch astma |
| French | Asthme intrinsèque |
| German | intrinsisches Asthma, Nichtallergisches Asthma bronchiale |
| Italian | Asma intrinseca |
| Portuguese | Asma intrínseca |
| Japanese | 内因性喘息, ﾅｲｲﾝｾｲｾﾞﾝｿｸ |
| Czech | Endogenní astma |
| Korean | 비알레르기성 천식 |
| Hungarian | Intrinsic asthma |
Ontology: Neutrophilic asthma (C2363774)
| Concepts | Disease or Syndrome (T047) |
| English | Neutrophilic asthma |
| Spanish | Asma neutrofílico |
| Dutch | neurofiele astma |
| German | neutrophiles Asthma |
| French | Asthme neutrophilique |
| Portuguese | Asma neutrofílica |
| Czech | Neutrofilní astma |
| Japanese | 好中球性喘息, ｺｳﾁｭｳｷｭｳｾｲｾﾞﾝｿｸ |
| Hungarian | Neutrophil asthma |
| Italian | Asma neutrofila |
