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Caspar Schiffers,1 Emiel FM Wouters,1,2 Robab Breyer-Kohansal,1,3 Roland Buhl,4 Wolfgang Pohl,5 Charles G Irvin,6 Marie-Kathrin Breyer,1,7 Sylvia Hartl1,7,8 1Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; 2NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; 3Department of Respiratory and Pulmonary Diseases, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria; 4Pulmonology Department, Mainz University Hospital, Mainz, Germany; 5Karl Landsteiner Gesellschaft, Institute for Clinical and Experimental Pneumology, Vienna, Austria; 6Pulmonary and Critical Care, Larner College of Medicine, University of Vermont, Burlington, VT, USA; 7Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria; 8Sigmund Freud University, Faculty for Medicine, Vienna, AustriaCorrespondence: Caspar Schiffers, Ludwig Boltzmann Institute for Lung Health, Vienna, 1140, Austria, Email caspar.schiffers@lunghealth.lbg.ac.atBackground: Asthma is a chronic heterogeneous respiratory disease involving differential pathophysiological pathways and consequently distinct asthma phenotypes.Objective and Methods: In the LEAD Study, a general population cohort (n=11.423) in Vienna ranging from 6– 82 years of age, we addressed the prevalence of asthma and explored inflammatory asthma phenotypes that included allergic and non-allergic asthma, and within these phenotypes, an eosinophilic (eosinophils ≥ 300 cells/μL, or ≥ 150 cells/μL in the presence of ICS medication) or non-eosinophilic (eosinophils < 300 cells/μL, or < 150 cells/μL in the presence of ICS) phenotype. In addition, we compared various factors related to biomarkers, body composition, lung function, and symptoms in control subjects versus subjects with current asthma (current doctor’s diagnosis of asthma).Results: An overall prevalence of 4.6% was observed for current asthma. Furthermore, an age-dependent shift from allergic to non-allergic asthma was found. The non-eosinophilic phenotype was more prominent. Obesity was a prevalent condition, and body composition including visceral adipose tissue (VAT), is affected in current asthma versus controls.Conclusion: This broad-aged and large general population cohort identified differential patterns of inflammatory asthma phenotypes that were age-dependent. The presence of eosinophilia was associated with worse asthma control, increased asthma medication, increased VAT, and lower lung function, the opposite was found for the presence of an allergic asthma.Keywords: asthma, prevalence, phenotyping, pulmonary function testing, spirometry, general population, body composition

Franziska Kölli,1,2 Marie-Kathrin Breyer,2,3 Sylvia Hartl,1– 3 Otto Burghuber,1,2 Emiel FM Wouters,2,4 Torben Sigsgaard,5 Wolfgang Pohl,6 Gabriele Kohlböck,2 Robab Breyer-Kohansal2,3 1Sigmund Freud University, Faculty of Medicine, Vienna, Austria; 2Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; 3Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria; 4NUTRIM School of Nutrition and Translational Research in Metabolism, University Medical Center, Maastricht, The Netherlands; 5Department of Public Health, Section of Environment, Occupation & Health, Aarhus University, Aarhus, Denmark; 6Karl Landsteiner Institute for Clinical and Experimental Pneumology, Clinic Hietzing, Vienna, AustriaCorrespondence: Franziska Kölli, Ludwig Boltzmann Institute for Lung Health, Sanatroium Street 2, Vienna, 1140, Austria, Tel +436645127500, Email franziskakoelli@gmx.atBackground: Monitoring of sensitization may become a non-invasive marker of impaired epithelial barrier function related to changing environmental conditions.Objective: To longitudinally evaluate the prevalence and associated factors for positive skin prick tests (SPT) in a general population cohort.Methods: Baseline and 4-year follow-up data from the longitudinal LEAD study are used for the current analyses. Risk factors for SPT were analyzed by multivariate binary logistic regression analyses, including residence (urban/rural), sex, socioeconomic status (SES), allergic and/or respiratory diseases, lung function testing, blood eosinophils, body composition, lifestyle habits, family history, pets in household, and exposure to tobacco smoke in childhood/adolescence (6– 18 years) and adulthood (≥ 19 years).Results: In total, 1439 children/adolescents and 9844 adults with valid SPTs were included in these analyses. The prevalence of sensitization at baseline was 37.6% and was higher in males in every age group, except 10–< 15 years. Individuals with doctor´s diagnosed allergy, asthma or parental allergy were more likely to have a positive SPT; in adulthood, sensitization was more common in those with a high SES. A lower occurrence of sensitization was associated with the presence of a dog in the household in childhood/adolescence and with smoking in adulthood. The prevalence and intensity (number of positive SPT reactions) increased after a 4-year follow-up, especially in children/adolescents.Conclusion: Sensitization is common in the general Austrian population and more likely in males than females. Longitudinal monitoring of sensitization in children/adolescents may identify environmental triggers related to changes in urbanization, industrialization and domestic lifestyle. ClinicalTrials.gov NCT01727518.Keywords: allergy, sensitization, aero-allergens, childhood/adolescence, adults

Abstract Background In patients with COPD progressive dyspnoea leads to a sedentary lifestyle. To date, no studies exist investigating the effects of Nordic Walking in patients with COPD. Therefore, the aim was to determine the feasibility of Nordic Walking in COPD patients at different disease stages. Furthermore we aimed to determine the short- and long-term effects of Nordic Walking on COPD patients' daily physical activity pattern as well as on patients exercise capacity. Methods Sixty COPD patients were randomised to either Nordic Walking or to a control group. Patients of the Nordic Walking group (n = 30; age: 62 ± 9 years; FEV1: 48 ± 19% predicted) underwent a three-month outdoor Nordic Walking exercise program consisting of one hour walking at 75% of their initial maximum heart rate three times per week, whereas controls had no exercise intervention. Primary endpoint: daily physical activities (measured by a validated tri-axial accelerometer); secondary endpoint: functional exercise capacity (measured by the six-minute walking distance; 6MWD). Assessment time points in both groups: baseline, after three, six and nine months. Results After three month training period, in the Nordic Walking group time spent walking and standing as well as intensity of walking increased (Δ walking time: +14.9 ± 1.9 min/day; Δ standing time: +129 ± 26 min/day; Δ movement intensity: +0.40 ± 0.14 m/s2) while time spent sitting decreased (Δ sitting time: -128 ± 15 min/day) compared to baseline (all: p < 0.01) as well as compared to controls (all: p < 0.01). Furthermore, 6MWD significantly increased compared to baseline (Δ 6MWD: +79 ± 28 meters) as well as compared to controls (both: p < 0.01). These significant improvements were sustained six and nine months after baseline. In contrast, controls showed unchanged daily physical activities and 6MWD compared to baseline for all time points. Conclusions Nordic Walking is a feasible, simple and effective physical training modality in COPD. In addition, Nordic Walking has proven to positively impact the daily physical activity pattern of COPD patients under short- and long-term observation. Clinical trial registration Nordic Walking improves daily physical activities in COPD: a randomised controlled trial - ISRCTN31525632