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2017 | 22 | 1 | 17-22
Article title

Fenotypy astmy oskrzelowej w starszym wieku

Title variants
Phenotypes of asthma in the elderly
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Astma występuje z podobną częstością w każdej grupie wiekowej. U osób starszych astma jest zbyt rzadko rozpoznawana lub błędnie rozpoznawana i niedostatecznie leczona. Leczenie starszych pacjentów jest często utrudnione przez współchorobowość, częstsze ograniczenia funkcji poznawczych, większe obciążenie chorobą oraz zmiany patofizjologiczne związane z wiekiem. W dobie medycyny spersonalizowanej lekarze wykorzystują podział fenotypowy dla ułatwienia diagnozowania i doboru właściwego sposobu leczenia. Często stosuje się podziały w zależności od aktualnego wieku pacjenta (astma dziecięca, dorosłych i osób starszych) lub wieku wystąpienia choroby (astma o wczesnym i późnym początku). Wśród osób starszych spotyka się podział związany z dominującymi komórkami zapalnymi, wyróżnia się astmę eozynofilową i neutrofilową. Często uwzględnia się problem współwystępowania otyłości i zaburzeń neuropsychiatrycznych u starszych pacjentów z astmą. W artykule przedstawiono najczęstsze metody klasyfikacji pacjentów z astmą oskrzelową, w tym metodę klastrową. Przedstawiono najważniejsze publikacje i opisane w nich cechy charakterystyczne dla każdej grupy
Asthma has similar prevalence in all age groups. In elderly patients asthma is often undiagnosed, wrongly diagnosed and/or undertreated. Treatment of elderly patients is troublesome because of comorbidities, more frequent cognitive limitations, greater burden of disease and pathophysiological process of aging. In the age of personalized medicine physicians use phenotypes to improve diagnostics and develop individual treatment. In the paper we discuss phenotypes of asthma in the elderly patients. Asthma can be differentiated to age (childhood asthma, adult asthma and elderly asthma) or the age of asthma onset (early and late asthma onset). Also, there is a classification based on the dominant inflammatory cells (eosinophilic asthma, neutrophilic asthma). Other phenotypes are connected with different comorbidities (obesity asthma phenotype, COPD, neuropsychiatric disorders). We describe classification methods including cluster analysis and point out the most important similarities within the groups.
Physical description
  • Klinika Immunologii, Reumatologii i Alergii Katedry Immunologii Klinicznej i Mikrobiologii Uniwersytetu Medycznego w Łodzi
  • Klinika Immunologii, Reumatologii i Alergii Katedry Immunologii Klinicznej i Mikrobiologii Uniwersytetu Medycznego w Łodzi
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