TY - JOUR
T1 - Near-fatal asthma: A heterogeneous clinical entity
AU - Serrano-Pariente, José
AU - Plaza, Vicente
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Copyright © 2017 Wolters Kluwer Health, Inc. Purpose of review The aims of the present review were to describe the heterogeneous nature of near-fatal asthma (NFA) and to summarize the distinctive phenotypes identified in this subtype of asthma. Recent findings Clinical, physiological, and histological studies have shown a large number of triggers, pathological mechanisms, and risk factors associated with NFA. Based on the demographic and clinical characteristics of the patients, the circumstances surrounding the asthma exacerbation and some distinctive features of the disease, several clinical profiles of asthma patients with NFA have been described. Recent data show new associations between some gene expression patterns and fatal asthma, as well as with some biological markers related to inflammatory or immunologic mechanisms in the airways. Also, the use of statistical methods, such as cluster analysis, allowed identifying and confirming different phenotypes of lifethreatening asthma patients. Summary NFA is a heterogeneous clinical entity, in which different patients' clinical profiles may coexist [e.g. rapidonset NFA, NFA in patients with dyspnea hypoperception or sensitized to certain pneumoallergens (Alternaria alternata, soybean), NFA related to the menstrual cycle, brittle asthma]. Knowledge of these phenotypes as well as adequate and specific management strategies can reduce morbidity and mortality in patients suffering from NFA.
AB - Copyright © 2017 Wolters Kluwer Health, Inc. Purpose of review The aims of the present review were to describe the heterogeneous nature of near-fatal asthma (NFA) and to summarize the distinctive phenotypes identified in this subtype of asthma. Recent findings Clinical, physiological, and histological studies have shown a large number of triggers, pathological mechanisms, and risk factors associated with NFA. Based on the demographic and clinical characteristics of the patients, the circumstances surrounding the asthma exacerbation and some distinctive features of the disease, several clinical profiles of asthma patients with NFA have been described. Recent data show new associations between some gene expression patterns and fatal asthma, as well as with some biological markers related to inflammatory or immunologic mechanisms in the airways. Also, the use of statistical methods, such as cluster analysis, allowed identifying and confirming different phenotypes of lifethreatening asthma patients. Summary NFA is a heterogeneous clinical entity, in which different patients' clinical profiles may coexist [e.g. rapidonset NFA, NFA in patients with dyspnea hypoperception or sensitized to certain pneumoallergens (Alternaria alternata, soybean), NFA related to the menstrual cycle, brittle asthma]. Knowledge of these phenotypes as well as adequate and specific management strategies can reduce morbidity and mortality in patients suffering from NFA.
KW - Asthma exacerbation
KW - Cluster analysis
KW - Fatal asthma
KW - Near-fatal asthma
KW - Phenotypes
U2 - 10.1097/ACI.0000000000000333
DO - 10.1097/ACI.0000000000000333
M3 - Review article
SN - 1528-4050
VL - 17
SP - 28
EP - 35
JO - Current Opinion in Allergy and Clinical Immunology
JF - Current Opinion in Allergy and Clinical Immunology
IS - 1
ER -