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The Adult Asthmatic

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Abstract

Asthma in the adult patient is a complex clinical syndrome. Multiple patient phenotypes and subphenotypes exist that contribute to disease heterogeneity. Whether adult asthma begins in utero, develops in childhood, or manifests for the first time in adulthood is not completely understood, nor are the mechanisms fully delineated. In this chapter, we update definitions that apply to this group, emphasize epidemiologic factors and pathogenic mechanisms, diagnosis, therapeutic options, and controversies regarding drug safety. Finally, we provide a brief discussion of biomarker technologies and novel therapies with the potential to impact adult-onset asthma outcomes.

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Abbreviations

FEV1 :

Forced expiratory volume in the 1st second

AOA:

Adult-onset asthma

LOA:

Late-onset asthma

GERD:

Gastroesophageal reflux disease

NAEPP-EPR3:

National Asthma Education and Prevention Program—Expert Panel Report 3

COPD:

Chronic obstructive pulmonary disease

CS:

Corticosteroid

ICS:

Inhaled corticosteroid

LABA:

Long-acting β-agonist

SABA:

Short-acting β-agonist

CDC:

Centers for disease control

HRT:

Hormone replacement therapy

CI:

Confidence interval

NSAID:

Non-steroidal anti-inflammatory drug

COX:

Cyclooxygenase

LT:

Leukotriene

GOLD:

Global obstructive lung disease

cys-LT:

Cysteinyl leukotriene

BMI:

Body mass index

RANTES:

Regulated upon activation, normal T cell expressed and secreted

GWA:

Genome-wide association

NO:

Nitric oxide

NOS:

Nitric oxide synthase

AHR:

Airway hyperresponsiveness

FENO :

Fraction of exhaled nitric oxide

EBC:

Exhaled breath condensate

PEF:

Peak expiratory flow

LTRA:

Leukotriene receptor antagonist

PC20 :

The provocative concentration or dose of methacholine that causes a 20% decrease in baseline FEV1

FDA:

Food and drug administration

SARP:

Severe Asthma Research Program

ACRN:

Asthma Clinical Research Network

PPARγ:

Peroxisome proliferator-activated receptor

PDE4:

Phosphodiesterase 4

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Authors and Affiliations

  1. UC Davis School of Medicine, Davis, CA, USA

    Amir A. Zeki, Nicholas J. Kenyon, Ken Yoneda & Samuel Louie

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  1. Amir A. Zeki
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  2. Nicholas J. Kenyon
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Correspondence to Amir A. Zeki.

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Zeki, A.A., Kenyon, N.J., Yoneda, K. et al. The Adult Asthmatic. Clinic Rev Allerg Immunol 43, 138–155 (2012). https://doi.org/10.1007/s12016-011-8260-4

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