Characteristics of Induced-Sputum Inflammatory Phenotypes in Adults with Asthma: Predictors of Bronchial Eosinophilia
Por:
Crespo-Lessmann A., Curto E., Medina, EFM, Palones E., Soler A.B., Maza S.S., Soto-Retes L., Plaza V.
Publicada:
1 ene 2023
Ahead of Print:
19 ene 2023
Resumen:
Purpose: 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.Patients and Methods: 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.Results: 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.Conclusion: 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.
Filiaciones:
Crespo-Lessmann A.:
Hosp Santa Creu & Sant Pau, Serv Neumol & Alergia, Barcelona, Spain
Inst Invest Biomed St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Serv Neumol & Alergia, Carrer Mas Casanovas 90, Barcelona 08041, Spain
Alergia Hosp Santa Creu & St Pau, Carrer Mas Casanovas 90, Barcelona 08041, Spain
Curto E.:
Hosp Santa Creu & Sant Pau, Serv Neumol & Alergia, Barcelona, Spain
Inst Invest Biomed St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Medina, EFM:
Hosp Santa Creu & Sant Pau, Serv Neumol & Alergia, Barcelona, Spain
Inst Invest Biomed St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Palones E.:
Hosp Santa Creu & Sant Pau, Serv Neumol & Alergia, Barcelona, Spain
Inst Invest Biomed St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Soler A.B.:
Hosp Santa Creu & Sant Pau, Serv Neumol & Alergia, Barcelona, Spain
Inst Invest Biomed St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Maza S.S.:
Hosp Santa Creu & Sant Pau, Serv Neumol & Alergia, Barcelona, Spain
Inst Invest Biomed St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Soto-Retes L.:
Hosp Santa Creu & Sant Pau, Serv Neumol & Alergia, Barcelona, Spain
Inst Invest Biomed St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Plaza V.:
Hosp Santa Creu & Sant Pau, Serv Neumol & Alergia, Barcelona, Spain
Inst Invest Biomed St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
gold, All Open Access; Gold
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