Characteristics of Induced-Sputum Inflammatory Phenotypes in Adults with Asthma : Predictors of Bronchial Eosinophilia
Crespo Lessmann, Astrid (Universitat Autònoma de Barcelona. Departament de Medicina)
Curto Sánchez, Elena (Universitat Autònoma de Barcelona. Departament de Medicina)
Mateus Medina, Eder Freddy (Universitat Autònoma de Barcelona. Departament de Medicina)
Palones, Esther (Universitat Autònoma de Barcelona. Departament de Medicina)
Belda Soler, Alicia (Universitat Autònoma de Barcelona. Departament de Medicina)
Sánchez Maza, Soraya (Universitat Autònoma de Barcelona. Departament de Medicina)
Soto-Retes, Lorena (Universitat Autònoma de Barcelona. Departament de Medicina)
Plaza, Vicente (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2023
Resum:	The objectives of this study were, for patients attending a specialist asthma clinic at a tertiary care hospital, to determine, from sputum induction (SI), proportions of bronchial inflammatory phenotypes, demographic, clinical and functional characteristics of each phenotype, and the most accessible non-invasive inflammatory marker that best discriminates between phenotypes. Included were 96 patients with asthma, attending a specialist asthma clinic at a tertiary care hospital, who underwent testing as follows: SI, spirometry, fractional exhaled nitric oxide (FeNO), blood eosinophilia, total immunoglobulin E (IgE), and a skin prick test. SI phenotypes were 46. 9% eosinophilic, 33. 3% paucigranulocytic, 15. 6% neutrophilic, and 4. 2% mixed. No significantly different clinical or functional characteristics were observed between the phenotypes. A positive correlation was observed between SI eosinophilia and both emergency visits in the last 12 months (p = 0. 041; r = 0. 214) and FeNO values (p = 0. 000; r = 0. 368). Blood eosinophilia correlated with SI eosinophilia (p = 0. 001; r = 0. 362) and was the best predictor of bronchial eosinophilia, followed by FeNO, and total blood IgE (area under the receiver operating characteristic curve (AUC-ROC) 72%, 65%, and 53%, respectively), although precision was only fair. In consultations for severe asthma, the most frequent phenotype was eosinophilic. Peripheral blood eosinophilia is a reliable marker for discriminating between different bronchial inflammatory phenotypes, is useful in enabling doctors to select a suitable biologic treatment and so prevent asthma exacerbation, and is a better predictor of bronchial eosinophilia than FeNO and IgE values.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Asthma ; Sputum induction ; Phenotype ; Eosinophilia
Publicat a:	Journal of Asthma and Allergy, Vol. 16 (january 2023) , p. 95-103, ISSN 1178-6965

DOI: 10.2147/JAA.S389402
PMID: 36699564

9 p, 875.7 KB

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