The evolution of asthma with old age

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This implies that asthma inflammation may decrease with age, but it does not say how much. Also, the patients' ability to cope with inflammation may also decrease with age.-------------Immun Ageing. 2010 Jul 5;7(1):8. [Epub ahead of print]Characterization of leukotrienes in a pilot study of older asthma subjects.Nyenhuis SM, Schwantes EA, Mathur SK.AbstractABSTRACT: BACKGROUND: Leukotrienes are pro-inflammatory lipid mediators, which are important in asthma leading to its characteristic features of airway bronchoconstriction, wheezing, increased mucus secretion and decreased mucociliary clearance. Aging results in changes in immune function and we have previously demonstrated age-related differences in levels of neutrophil elastase, MMP-9, and IL-8 in asthma subjects. We sought to determine whether leukotriene levels differed between young and older asthmatics. RESULTS: In this pilot study, we measured leukotriene B4 (LTB4) and leukotriene C4 (LTC4) production in neutrophils and eosinophils, respectively, stimulated with calcium ionophore in vitro. Sputum samples were analyzed for LTB4 and cysteinyl leukotrienes (cysLT). Analysis of data was performed as a comparison between the younger and older age groups. Sputum analysis revealed a tendency towards a higher percentage of neutrophils in older asthma subjects. No age-related differences were found for in vitro leukotriene production. However, LTB4 was significantly decreased in the airway of older adults with asthma and there was a strong tendency of lower levels of cysLT. In addition, there was an age-related decrease in GM-CSF production in peripheral blood mononuclear cells (PBMCs), which may account for the diminished production of leukotrienes in the airway of older asthmatics. CONCLUSION: This pilot study revealed age-related changes in sputum leukotriene levels. This demonstrates a key difference in the airway inflammatory state in older asthmatics, which may have therapeutic relevance regarding response to asthma treatments.