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Severe asthma linked to gender, obesity and aspirin intolerance

Clinical factors such as gender and obesity may lead to the development of difficult-to-treat asthma, according to researchers at Japan’s Kanazawa University.

There are a number of clinically distinct forms of asthma which can be split into two main groups – atopic asthma, triggered by allergies such as hayfever, and non-atopic asthma which is not caused by a definite allergy. Difficult-to-treat asthma (DTA) is diagnosed when a patient remains symptomatic in spite of high doses of treatment. These patients often require regular emergency medical attention, and are therefore of considerable concern to healthcare providers.

With this in mind, Yuma Fukutomi and co-workers at Kanazawa University and Sagamihara National Hospital, Kanagawa, have completed a study of over 1000 Japanese asthma patients in order to examine correlations between DTA and clinical factors such as gender and body mass index (BMI).

The Japanese patients represented a homogenous ethnic group, meaning that the researchers could focus on other clinical factors. Statistical analyses of both DTA and controlled-asthma patients showed that obese women with a non-atopic form of asthma were three times more likely to suffer from DTA than women with a normal BMI. Similarly, female patients with non-atopic asthma and proven aspirin intolerance had an increased chance of developing DTA.

Further research is required into the mechanisms that link gender, obesity and DTA. It is thought that sex hormones may help modulate these relationships, and that the same hormones could also play a role in aspirin intolerance. In the meantime, Fukutomi and his team suggest that phenotype-specific treatment of DTA is required in high risk patients.

Publication and Affiliation
Y. Fukutomi*1,2, M. Taniguchi1, T. Tsuburai1, H. Tanimoto1, C. Oshikata1, E. Ono1, K. Sekiya1, N. Higashi1, A. Mori1, M. Hasegawa1, H. Nakamura2 & K. Akiyama1. Obesity and aspirin intolerance are risk factors for difficult-to-treat asthma in Japanese non-atopic women. Clinical & Experimental Allergy (42) 738–746 (2012) DOI: 10.1111/j.1365-2222.2011.03880.x Link

1. Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa 252-0392, Japan
2. Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan

*corresponding author, e-mail address: Yuma Fukutomi: y-fukutomi@sagamiharahosp.gr.jp

ID: 201302H019

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