General Risk Factors and Inflammatory Determinants in Older Patients With Asthma

Inclusion Criteria Asthma patients: * Age between 18-80 years * Smoking history of \< 10 packyears (PY) * Willing and able to comply with the study protocol * Asthma diagnosis is based on presence of typical clinical symptoms, reversible airway obstruction (+12% improvement in forced expiratory volume at one second (FEV1) after bronchodilator) or bronchial hyperreactivity (PC20 \< 8 mg/ml) or a (fractional exhaled nitric oxide) FeNO \> 50 ppb. - All asthma patients have (Global Initiative for Asthma ) GINA step 4-5 medication (high dose ICS/LABA). * Asthma control questionaire (ACQ) \> 0,75 * Written informed consent. Inclusion Criteria Healthy controls:\\Inclusion criteria healthy control: * Written informed consent * Age between 18-80 years. Exclusion Criteria: * Smoking history of \> 10 PY * Age \< 18 years or \> 80 years * Not able to speak or write Dutch language. * Not able to perform lung function test/sputum induction * ACQ \< 0,75 * Other diseases which could influence pulmonary function and/or the immune system such as: o A possible infection of the upper- or lower respiratory tract 4 weeks prior to the collection of materials; * Chronic obstructive pulmonary disorder (COPD) in the medical history; * Auto-immune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), myasthenia gravis or Goodpasture's syndrome; * Malignancies; * Inherited or acquired immunodeficiency * Pregnancy; Exclusion criteria healthy controls: * Asthma, as defined earlier (page 13); * An abnormal spirometry with a forced vital capacity (FVC) or FEV1 below the 80% of the predicted value * A liaison with the coordinating or principal investigator, which could likely influence the decision to participate in this study voluntarily (in concordance with the World Meteorological Organization (WMO) -article 5);