Clinical features of allergic and non-allergic asthma in adults_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WEI Meihui ^# , HE Lixiu ^#△ , YANG Ling , YANG Jing , LUO Jian ,  LIU Chuntao

Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China;

Corresponding author：

LIU Chuntao, Email: taosen666@vip.163.com

Keywords：

Asthma; Allergy; Airflow obstruction; Fractional exhaled nitric oxide

DOI：

10.7507/1671-6205.201611042

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the clinical characteristics of allergic and non-allergic asthma in Chinese adult asthmatic patients. Methods Consecutive treatment-naive adult outpatients with asthma were retrospectively analyzed in West China Hospital, Sichuan University from October 2014 to June 2016. The patients were classified into a non-allergic asthma (NAAS) group and an allergic asthma (AAS) group by skin prick test or antigen-specific IgE test. The differences between allergic and non-allergic asthma were compared in respect of gender, age, asthma control test (ACT) score, lung function, fractional exhaled nitric oxide (FeNO) level, body mass index (BMI), disease severity,etc. Results A total of 131 patients were enrolled in which 72 cases (54.96%) were allergic asthmatics and 59 cases (45.04%) were non-allergic asthmatics. The level of FeNO was statistically different (t=–2.762,P=0.007) between the NAAS group and the AAS group [(51.1±32.6)ppbvs. (69.1±41.7)ppb]. Seventeen cases of the NAAS group and 48 cases of the AAS group were complicated with rhinitis with statistically significant difference (χ² =19.396,P=0.000). Airway limitation reversibility test showed that there were 37 cases in AAS and 20 cases in NAAS with no airway obstruction (NAO), 26 cases in AAS and 22 cases in NAAS with reversible airflow obstruction (RAO), 9 cases in AAS and 17 cases in NAAS with irreversible airflow obstruction (IAO), respectively, with statistically significant difference between two groups (Z=–2.461,P=0.014). There were 20 cases (33.9%) in NAAS and 37 cases (51.4%) in AAS with mild intermittent or persistent asthma, 18 cases (30.5%) in NAAS and 19 cases (26.4%) in AAS with moderate persistent asthma, 21 cases (35.6%) in NAAS and 16 (22.2%) in AAS with severe persistent asthma, respectively, with statistically significant difference (Z=–2.115,P=–0.034). The age, ACT score, FEV₁%pred, and BMI had no statistical difference between two groups (allP>0.05). Conclusion Compared with allergic asthma, non-allergic asthma has less rhinitis, lower FeNO levels and higher prevalence of irreversible airflow obstruction.

Citation： WEI Meihui, HE Lixiu, YANG Ling, YANG Jing, LUO Jian, LIU Chuntao. Clinical features of allergic and non-allergic asthma in adults. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(3): 212-216. doi: 10.7507/1671-6205.201611042 Copy

1.	Global Initiative for Asthma. Global strategy for asthma management and prevention 2016. Available at: .
2.	Rackemann FM. A working classification of asthma. Am J Med, 1947, 3(5): 601-606.
3.	Burrows B, Martinez FD, Halonen M, et al. Association of asthma with serum IgE levels and skin-test reactivity to allergens. N Engl J Med, 1989, 320(5): 271-277.
4.	Humbert M, Menz G, Ying S, et al. The immunopathology of extrinsic (atopic) and intrinsic (non-atopic) asthma: more similarities than differences. Immunology Today, 1999, 20(11): 528-533.
5.	Kwon B, Lee H, Choi G, et al. Increased IgG antibody-induced cytotoxicity against airway epithelial cells in patients with nonallergic asthma. J Clin Immunol, 2009, 29(4): 517-523.
6.	Nieves A, Magnan A, Boniface S, et al. Phenotypes of asthma revisited upon the presence of atopy. Respir Med, 2005, 99(3): 347-354.
7.	中华医学会呼吸病学分会哮喘学组. 支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗和管理方案). 中华结核和呼吸杂志, 2008, 31(3): 177-185.
8.	Brożek JL, Bousquet J, Baena-Cagnani CE, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 Revision. J Allergy Clin Immunol, 2010, 126(3): 466-476.
9.	Dweik RA, Boggs PB, Erzurum SC, et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med, 2011, 184(5): 602-615.
10.	Brown PJ, Greville HW, Finucane KE. Asthma and irreversible airflow obstruction. Thorax, 1984, 39(2): 131-136.
11.	Barnes PJ. Intrinsic asthma: not so different from allergic asthma but driven by superant IgE ns?. Clin Exp Allergy, 2009, 39(8): 1145-1151.
12.	Romanet-Manent S, Charpin D, Magnan A, et al. Allergic vs nonallergic asthma: what makes the difference?. Allergy, 2002, 57(7): 607-613.
13.	Warm K, Backman H, Lindberg A, et al. Low incidence and high remission of allergic sensitization among adults. J Allergy Clin Immunol, 2012, 129(1): 136-142.
14.	Leynaert B, Sunyer J, Garcia-Esteban R, et al. Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma: a population-based cohort. Thorax, 2012, 67(7): 625-631.
15.	Appleton SL, Adams RJ, Wilson DH, et al. Central obesity is associated with nonatopic but not atopic asthma in a representative population sample. J Allergy Clin Immunol, 2006, 118(6): 1284-1291.
16.	van den Berge M, Heijink HI, van Oosterhout AJM, et al. The role of female sex hormones in the development and severity of allergic and non-allergic asthma. Clin Exp Allergy, 2009, 39(10): 1477-1481.
17.	Turktas H, Oguzulgen K, Kokturk N, et al. Correlation of exhaled nitric oxide levels and airway inflammation markers in stable asthmatic patients. J Asthma, 2003, 40(4): 425-430.
18.	Nogami H, Shoji S, Nishima S. Exhaled nitric oxide as a simple assessment of airway hyperresponsiveness in bronchial asthma and chronic cough patients. J Asthma, 2003, 40(6): 653-659.
19.	Malmberg LP, Turpeinen H, Rytila P, et al. Determinants of increased exhaled nitric oxide in patients with suspected asthma. Allergy, 2005, 60(4): 464-468.
20.	Crespo A, Giner J, Torrejon M, et al. Clinical and inflammatory features of asthma with dissociation between fractional exhaled nitric oxide and eosinophils in induced sputum. J Asthma, 2016, 53(5): 459-464.
21.	Brusselle GG, Maes T, Bracke KR. Eosinophils in the spotlight: eosinophilic airway inflammation in nonallergic asthma. Nat Med, 2013, 19(8): 977-979.
22.	Wenzel SE. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med, 2012, 18(5): 716-725.
23.	Matsunaga K, Hirano T, Oka A, et al. Progression of irreversible airflow limitation in asthma: correlation with severe exacerbations. J Allergy Clin Immunol Pract, 2015, 3(5): 759-764.
24.	张永明, 林江涛, 苏楠, 等. 支气管哮喘患者气道炎症表型研究. 中华结核和呼吸杂志, 2015, 38(5): 348-351.
25.	Agache I, Akdis C, Jutel M, et al. Untangling asthma phenotypes and endotypes. Allergy, 2012, 67(7): 835-846.
26.	Bousquet J, Van Cauwenberge P, Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol, 2001, 108(5 Suppl): S147-S334.

1. Global Initiative for Asthma. Global strategy for asthma management and prevention 2016. Available at: .
2. Rackemann FM. A working classification of asthma. Am J Med, 1947, 3(5): 601-606.
3. Burrows B, Martinez FD, Halonen M, et al. Association of asthma with serum IgE levels and skin-test reactivity to allergens. N Engl J Med, 1989, 320(5): 271-277.
4. Humbert M, Menz G, Ying S, et al. The immunopathology of extrinsic (atopic) and intrinsic (non-atopic) asthma: more similarities than differences. Immunology Today, 1999, 20(11): 528-533.
5. Kwon B, Lee H, Choi G, et al. Increased IgG antibody-induced cytotoxicity against airway epithelial cells in patients with nonallergic asthma. J Clin Immunol, 2009, 29(4): 517-523.
6. Nieves A, Magnan A, Boniface S, et al. Phenotypes of asthma revisited upon the presence of atopy. Respir Med, 2005, 99(3): 347-354.
7. 中华医学会呼吸病学分会哮喘学组. 支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗和管理方案). 中华结核和呼吸杂志, 2008, 31(3): 177-185.
8. Brożek JL, Bousquet J, Baena-Cagnani CE, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 Revision. J Allergy Clin Immunol, 2010, 126(3): 466-476.
9. Dweik RA, Boggs PB, Erzurum SC, et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med, 2011, 184(5): 602-615.
10. Brown PJ, Greville HW, Finucane KE. Asthma and irreversible airflow obstruction. Thorax, 1984, 39(2): 131-136.
11. Barnes PJ. Intrinsic asthma: not so different from allergic asthma but driven by superant IgE ns?. Clin Exp Allergy, 2009, 39(8): 1145-1151.
12. Romanet-Manent S, Charpin D, Magnan A, et al. Allergic vs nonallergic asthma: what makes the difference?. Allergy, 2002, 57(7): 607-613.
13. Warm K, Backman H, Lindberg A, et al. Low incidence and high remission of allergic sensitization among adults. J Allergy Clin Immunol, 2012, 129(1): 136-142.
14. Leynaert B, Sunyer J, Garcia-Esteban R, et al. Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma: a population-based cohort. Thorax, 2012, 67(7): 625-631.
15. Appleton SL, Adams RJ, Wilson DH, et al. Central obesity is associated with nonatopic but not atopic asthma in a representative population sample. J Allergy Clin Immunol, 2006, 118(6): 1284-1291.
16. van den Berge M, Heijink HI, van Oosterhout AJM, et al. The role of female sex hormones in the development and severity of allergic and non-allergic asthma. Clin Exp Allergy, 2009, 39(10): 1477-1481.
17. Turktas H, Oguzulgen K, Kokturk N, et al. Correlation of exhaled nitric oxide levels and airway inflammation markers in stable asthmatic patients. J Asthma, 2003, 40(4): 425-430.
18. Nogami H, Shoji S, Nishima S. Exhaled nitric oxide as a simple assessment of airway hyperresponsiveness in bronchial asthma and chronic cough patients. J Asthma, 2003, 40(6): 653-659.
19. Malmberg LP, Turpeinen H, Rytila P, et al. Determinants of increased exhaled nitric oxide in patients with suspected asthma. Allergy, 2005, 60(4): 464-468.
20. Crespo A, Giner J, Torrejon M, et al. Clinical and inflammatory features of asthma with dissociation between fractional exhaled nitric oxide and eosinophils in induced sputum. J Asthma, 2016, 53(5): 459-464.
21. Brusselle GG, Maes T, Bracke KR. Eosinophils in the spotlight: eosinophilic airway inflammation in nonallergic asthma. Nat Med, 2013, 19(8): 977-979.
22. Wenzel SE. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med, 2012, 18(5): 716-725.
23. Matsunaga K, Hirano T, Oka A, et al. Progression of irreversible airflow limitation in asthma: correlation with severe exacerbations. J Allergy Clin Immunol Pract, 2015, 3(5): 759-764.
24. 张永明, 林江涛, 苏楠, 等. 支气管哮喘患者气道炎症表型研究. 中华结核和呼吸杂志, 2015, 38(5): 348-351.
25. Agache I, Akdis C, Jutel M, et al. Untangling asthma phenotypes and endotypes. Allergy, 2012, 67(7): 835-846.
26. Bousquet J, Van Cauwenberge P, Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol, 2001, 108(5 Suppl): S147-S334.

Previous Article
倡导大呼吸的理念
Next Article
Effects of transforming growth factor beta on airway remodeling of obese asthmatic mice treated with pirfenidone

Chinese Journal of Respiratory and Critical Care Medicine

Clinical features of allergic and non-allergic asthma in adults

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content