Th-2 signature in chronic airway diseases: towards the extinction of asthma-COPD overlap syndrome?
Por:
Cosio, BG, de Llano, LP, Vina, AL, Torrego, A, Lopez-Campos, JL, Soriano, JB, Moragon, EM, Izquierdo, JL, Bobolea, I, Callejas, J, Plaza, V, Miravitlles, M, Soler-Catalunya, JJ
Publicada:
1 may 2017
Resumen:
We aimed to describe the differences and similarities between patients with chronic obstructive airway disease classified on the basis of classical diagnostic labels (asthma, chronic obstructive pulmonary disease (COPD), or asthma-COPD overlap (ACOS)) or according to the underlying inflammatory pattern (Th-2 signature, either Th-2-high or Th-2-low).
We performed a cross-sectional study of patients aged >= 40 years and with a post-bronchodilator forced expiratory volume in 1 s to forced vital capacity ratio <= 0.7 with a previous diagnosis of asthma (nonsmoking asthmatics (NSA)), COPD or ACOS, the latter including both smoking asthmatics (SA) and patients with eosinophilic COPD (COPD-e). Clinical, functional and inflammatory parameters (blood eosinophil count, IgE and exhaled nitric oxide fraction (FeNO)) were compared between groups. Th-2 signature was defined by a blood eosinophil count >= 300 cells.mu L-1 and/or a sputum eosinophil count >= 3%.
Overall, 292 patients were included in the study: 89 with COPD, 94 NSA and 109 with ACOS (44 SA and 65 with COPD-e). No differences in symptoms or exacerbation rate were found between the three groups. With regards the underlying inflammatory pattern, 94 patients (32.2%) were characterised as Th2- high and 198 (67.8%) as Th-2-low. The Th-2 signature was found in 49% of NSA, 3.3% of patients with COPD, 30% of SA and 49.3% of patients with COPD-e. This classification yielded significant differences in demographic, functional and inflammatory characteristics.
We conclude that a classification based upon the inflammatory profile, irrespective of the taxonomy, provides a more clear distinction of patients with chronic obstructive airway disease.
Filiaciones:
Cosio, BG:
Hosp Univ Son Espases IdISBa & Ciberes, Dept Resp Med, Palma De Mallorca, Spain
de Llano, LP:
Hosp Lucus Augusti, Dept Resp Med, Lugo, Spain
Vina, AL:
Hosp Puerta Hierro, Dept Resp Med, Madrid, Spain
Torrego, A:
Hosp Santa Creu & Sant Pau, Dept Resp Med, Barcelona, Spain
Lopez-Campos, JL:
Hosp Virgen Rocio, Dept Resp Med, Seville, Spain
Soriano, JB:
Univ Autonoma Madrid, Hosp Princesa, Catedra Linde, Madrid, Spain
Moragon, EM:
Hosp Dr Peset, Dept Resp Med, Valencia, Spain
Izquierdo, JL:
Hosp Univ Guadalajara, Dept Resp Med, Guadalajara, Spain
Bobolea, I:
Hosp 12 Octubre, Dept Allergy, Madrid, Spain
Callejas, J:
Hosp Univ Albacete, Dept Resp Med, Albacete, Spain
Plaza, V:
Hosp Santa Creu & Sant Pau, Dept Resp Med, Barcelona, Spain
Miravitlles, M:
Hosp Univ Vall dHebron, Dept Resp Med, Barcelona, Spain
Soler-Catalunya, JJ:
Hosp Arnau Vilanova, Dept Resp Med, Valencia, Spain
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