Allergology International
Online ISSN : 1440-1592
Print ISSN : 1323-8930
ISSN-L : 1323-8930
Review Series: What We Know, Do Not Know, and Should Know about Severe Asthma
Severe asthma in Japan
Hiroyuki Nagase
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2019 Volume 68 Issue 2 Pages 167-171

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Abstract

The characteristic phenotype of severe asthma in Japan seems to be distilled into the following two features: low incidence of obesity and high prevalence of patients with type 2 inflammation. Only 5–7% of Japanese severe asthma patients had a body mass index (BMI) ≥30 kg/m2, and more than 80% of patients with severe asthma exhibited type 2 inflammation. Although the relationship between obesity and non-type 2 inflammation is complex, the low incidence of obesity might explain the prevalence of type 2 inflammation.

Some asthma cohorts in Japan have investigated the roles of type 2 biomarkers extensively, including periostin, to identify a severe phenotype, suggesting the utility of combining biomarkers to identify an exacerbation-prone subgroup.

Although the prevalence of severe asthma is comparable to Western countries, the rate of asthma death and disease burden seems to be lower in Japan. These trends might be due to the system of public health insurance for the whole nation, leading to good access to hospital and asthma specialists due to the geographically narrow country.

In this review article, we will discuss the definition, epidemiology, comorbidities, biomarkers, specific phenotype, and current treatment for severe asthma in Japan.

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© 2019 by Japanese Society of Allergology
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