Page 170 - ADULT-ONSET ASTHMA PREDICTORS OF CLINICAL COURSE AND SEVERITY

ADULT-ONSET ASTHMA – PREDICTORS OF CLINICAL COURSE AND SEVERITY
marker of the in ammatory process. For example oxida ve stress (markers like 8-isoprostane and 4-hydroxynonenal (HNE)), or signs of systemic in amma on like CRP, IL6 and CD163 have been shown to be associated with poor lungfunc on and neutrophilic in amma on.33-35 Levels of soluble IL6 receptor in serum are associated with more severe asthma and with lower lung func on.36 In obese asthma pa ents levels of adipokines might be of interest: lep n and adiponec ne.
What would be the therapeu c consequences of non-eosinophilic asthma is ques onable. Elimina on of neutrophils or ac va ng interleukins could theore cally be bene cial. However, these cells do play a crucial role in innate immunity. Trials with an -Il-8 or an -Il-17 an bodies have failed to show signi cant improvement of asthma outcomes. An -TNFα also showed no bene cial e ect on asthma.37 Macrolide an bio cs have been shown to reduce the exacerba on rate in non-eosinophilic asthma, the exact working mechanism remains to be elucidated.38 Unfortunately are the therapeu c possibili es for pa ents with non-eosinophilic asthma very limited un l now and deserve more a en on in future research.
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