Brittle Asthma: Still on Board?

Author:

Visca Dina12,Ardesi Francesco2ORCID,Centis Rosella3,Pignatti Patrizia4ORCID,Spanevello Antonio12

Affiliation:

1. Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, 21049 Tradate, Italy

2. Department of Medicine and Surgery, University of Insubria, 2100 Varese, Italy

3. Clinical Epidemiology of Respiratory Diseases Service, Istituti Clinici Scientifici Maugeri, IRCCS, 21049 Tradate, Italy

4. Allergy and Immunology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, 27100 Pavia, Italy

Abstract

(1) Background: “Brittle Asthma” was considered an asthma clinical phenotype and deemed to be life-threatening in the early 2000s; then, this definition disappeared. The purpose of this review is to examine what has historically been referred to as this term and see whether it may be applied to modern clinical practice, thus acquiring fresh relevance and meaning. (2) Methods: A non-systematic search of the literature was conducted using both MeSH and free-text phrases. No limitations on the research design or type of publication were applied. (3) Results: Reliable data regarding “Brittle Asthma” are lacking due to the paucity of current data and the few studies available. After a few years of reworking, it was divided into two sub-classes: one characterized by a wide PEF variability despite high-dose therapy and the other by sudden acute attacks in otherwise apparently normal airway functions or well-controlled asthma. Their characteristics were hardly defined because of their low prevalence. Data regarding risk factors, atopy, mechanisms, and treatments were analyzed. (4) Conclusions: Over time, different terminology has been introduced to define asthma severity and control. It would be worth investigating whether the term “Brittle Asthma” previously used may be helpful to find new hints to stratify patients and improve disease management.

Funder

Ricerca Corrente scheme of the Ministry of Health

Publisher

MDPI AG

Subject

General Biochemistry, Genetics and Molecular Biology,Medicine (miscellaneous)

Reference77 articles.

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3. Asthma phenotypes: The evolution from clinical to molecular approaches;Wenzel;Nat. Med.,2012

4. Identification of asthma phenotypes using cluster analysis in the severe asthma research program;Moore;Am. J. Respir. Crit. Care Med.,2010

5. Clinical phenotypes of asthma;Bel;Curr. Opin. Pulm. Med.,2004

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