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Asthma could be several diseases masquerading as one

People who develop asthma as children may have a different disease than those who develop it as an adult. A study in the January issue of The Journal of Allergy and Clinical Immunology adds to the growing body of evidence that asthma is not a single disease, but a group of syndromes with different origins and biological characteristics. The research team, led by Sally Wenzel, M.D., a pulmonologist at National Jewish Medical and Research Center, also found that the absence or presence of inflammatory cells, called eosinophils, helped distinguish differences among asthma patients.

"We found that patients whose asthma began in childhood were more frequently allergic than those whose asthma began as adults, while adult-onset asthma was associated with more rapid loss of lung function," said Wenzel. "We were surprised to find that many patients showed no signs of inflammation, generally considered a hallmark of the asthma, yet they still had severe airflow limitation and many asthma symptoms."

The study represents the first time that a research team has combined information from a detailed questionnaire with extensive biological data to define subsets of asthma patients. This data should help physicians better diagnose and treat their asthma patients and make better predictions about the course of their disease. The data may also help guide the search for genetic causes of the disease.

The researchers studied 80 patients with severe asthma who had been referred to National Jewish Medical and Research Center because high doses of inhaled or oral steroids had failed to control their symptoms. Patients were divided into those whose asthma developed before 12 years of age and those whose asthma developed later. The early-onset group developed asthma at the mean age of 2.6 years, while the late-onset group developed asthma at the mean age of 27. They were evaluated for differences in allergic responses, symptoms, lung function and pathology.

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Contact: William Allstetter
allstetterw@njc.org
303-398-1002
National Jewish Medical and Research Center
8-Jan-2004


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