Menopausal asthma: a new biological phenotype?
BACKGROUND
Female hormones play an important role in women's lung health, especially in asthma pathophysiology. Although a growing interest has recently been aroused in asthma related to short-term reproductive states, menopausal asthma has been little studied in the past. The aim of the present study was to explore airway inflammation in menopausal asthmatic women in a noninvasive manner.


METHODS
Forty consecutive women with menopausal asthma, 35 consecutive women with premenopausal asthma and 30 age-matched healthy controls were enrolled in the study. Urinary LTE-4, induced sputum inflammatory cells, and exhaled LTE-4, IL-6, pH, and NO levels were measured in all the subjects enrolled.


RESULTS
Women with menopausal asthma showed decreased estradiol concentrations, high sputum neutrophils, and exhaled IL-6. Women with premenopausal asthma presented instead an essentially eosinophilic inflammatory pattern. Higher urine and breath condensate LTE-4 concentrations were found in premenopausal and menopausal asthma compared to controls.


CONCLUSIONS
Our results substantiate the existence of a new biological phenotype of menopausal asthma that is mainly characterized by neutrophilic airways inflammation and shares several characteristics of the severe asthma phenotype.
Foschino Barbaro
M P
MP
Institute of Respiratory Disease, Department of Medical and Occupational Sciences, University of Foggia, Foggia, Italy.
Costa
V R
VR
Resta
O
O
Prato
R
R
Spanevello
A
A
Palladino
G P
GP
Martinelli
D
D
Carpagnano
Giovanna Elisiana
GE
D001249:Asthma / Q000473:pathology / Q000503:physiopathology; D016022:Case-Control Studies; D004804:Eosinophils; D045853:Exhalation; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007249:Inflammation / Q000473:pathology; D015847:Interleukin-4 / Q000032:analysis; D017999:Leukotriene E4 / Q000032:analysis / Q000652:urine; D008593:Menopause; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D009569:Nitric Oxide / Q000032:analysis; D010641:Phenotype; D017697:Premenopause; D013183:Sputum
D015847:Interleukin-4; D009569:Nitric Oxide; D017999:Leukotriene E4