There is an association between vaccine-associated aluminum and persistent asthma among children with and without eczema, according to a study published in Academic Pediatrics. Matthew F. Daley, MD, and colleagues conducted a retrospective cohort study in the Vaccine Safety Datalink to examine the association between cumulative aluminum exposure from vaccines before age 24 months and persistent asthma at age 25-59 months. Data were included from 326,991 children, among whom 4.4% had eczema. The mean vaccine associated aluminum exposure levels were 4.07 mg and 3.98 mg for children with and without eczema, respectively. Overall, 6.0% and 2.1% of children with and without eczema, respectively, developed persistent asthma. Vaccine-associated aluminum was positively associated with persistent asthma among children with eczema (adjusted HR, 1.26 per 1-mg increase in aluminum) and among children without eczema (adjusted HR, 1.19 per 1-mg increase in aluminum). “This [CDC]-funded study has important limitations that the authors
acknowledge, and CDC is not changing the current routine childhood vaccination recommendations based on this single study,” the agency wrote in a statement.

Asthma in Elderly Patients Denotes a Specific Phenotype

Aging can affect asthma in terms of exacerbations, clinical and inflammatory characteristics, and response to treatment, according to a study published in The Journal of Allergy and Clinical Immunology: In Practice. Gang Wang, MD, PhD, and colleagues conducted a prospective cohort study of patients with asthma in a real-word setting with a 12-month follow-up period. Future risk for exacerbations; clinical, inflammatory, and phenotypic characteristics; and response to treatment were examined across age groups (young: 18-39; middle-aged: 40-64; and elderly: 65 and older). Elderly patients with asthma (N=55) had more comorbidities (such as diabetes and COPD), had worse airway obstruction, less atopy, and were more likely to have late onset and fixed airflow obstruction asthma, compared with middle- aged (N=179) and young (N=106) patients with asthma. Elderly patients with asthma also had considerably increased levels of IL8, IFN-γ, and IL-17A in induced sputum (all P<0.05). Additionally, elderly patients exhibited a decreased response to treatment.