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Author Notes:

Contact Author: W. Gerald Teague, MD, Ivy Foundation Distinguished Professor of Pediatrics, Associate Director, Child Health Research Center, Chief, Division of Respiratory Medicine, Allergy, and Immunology, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA 22908, wgt2p@virginia.edu; Phone: 434-243-0613.

The authors acknowledge the contributions of the study coordinators and staff at each of the clinical centers and the Data Coordinating Center as well as all the study participants that have been integral to the success of the Severe Asthma Research Program.

Spirometers used in SARP III were provided by nSpire Health (Longmont, CO).

The authors appreciate the support of the Scientific Program Officers at the National Heart, Lung and Blood Institute (Dr. Patricia Noel, Dr. Tom Croxton, and Dr. Robert Smith) and input from the members of the Data Safety and Monitoring Board.


Research Funding:

Eugene R. Bleecker, PI, Wake Forest University, U10 HL109164

Mario Castro, PI, Washington University, U10 HL109257

John V. Fahy, PI, University of California San Francisco, U10 HL109146

Elliot Israel and Bruce Levy, Co-PI’s, Brigham and Women’s Hospital, U10 HL109172

Ben Gaston, PI, Case Western Univ. Virginia-Cleveland Consortium, U10 HL109250

Serpil Erzurum, Co-PI, Cleveland Clinic, Virginia-Cleveland Consortium, U10 HL109250

W. Gerald Teague, Co-PI, Univ. of Virginia, Virginia-Cleveland Consortium, U10 HL109250

Nizar N. Jarjour, PI, University of Wisconsin, U10 HL109168

Sally E. Wenzel, PI, University of Pittsburgh, U10 HL109152

David T. Mauger, PI, DCC, Penn State University, U10 HL109086-04


  • Science & Technology
  • Life Sciences & Biomedicine
  • Allergy
  • Immunology
  • Severe asthma
  • Asthma phenotypes
  • LUNG

Baseline Features of the Severe Asthma Research Program (SARP III) Cohort: Differences with Age

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Journal Title:

Journal of Allergy and Clinical Immunology: In Practice


Volume 6, Number 2


, Pages 545-+

Type of Work:

Article | Post-print: After Peer Review


Background: The effect of age on asthma severity is poorly understood. Objectives: The objective of this study was to compare the baseline features of severe and nonsevere asthma in the Severe Asthma Research Program (SARP) III cohort, and examine in cross section the effects of age on those features. Methods: SARP III is a National Institutes of Health/National Heart Lung Blood Institute multisite 3-year cohort study conducted to investigate mechanisms of severe asthma. The sample included 188 children (111 severe, 77 nonsevere) and 526 adults (313 severe, 213 nonsevere) characterized for demographic features, symptoms, health care utilization, lung function, and inflammatory markers compared by age and severity. Results: Compared with children with nonsevere asthma, children with severe asthma had more symptoms and more historical exacerbations, but no difference in body weight, post-bronchodilator lung function, or inflammatory markers. After childhood, and increasing with age, the cohort had a higher proportion of women, less allergen sensitization, and overall fewer blood eosinophils. Enrollment of participants with severe asthma was highest in middle-aged adults, who were older, more obese, with greater airflow limitation and higher blood eosinophils, but less allergen sensitization than adults with nonsevere asthma. Conclusions: The phenotypic features of asthma differ by severity and with advancing age. With advancing age, patients with severe asthma are more obese, have greater airflow limitation, less allergen sensitization, and variable type 2 inflammation. Novel mechanisms besides type 2 inflammatory pathways may inform the severe asthma phenotype with advancing age.

Copyright information:

© 2017 The Authors

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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