PMID: identifier of
Pubmed reference: |
 |
 (19131450) |
|
| title: |
|
Heterogeneity of asthma according to blood inflammatory patterns. |
|
| author(s): |
|
Rachel Nadif ( ) 1, Valérie Siroux2, Marie-Pierre Oryszczyn1, Coralie Ravault1, 3, Christophe Pison1, Isabelle Pin2, 4, Francine Kauffmann1, For the EGEA collaboration(s) |
|
| laboratory: |
|
|
|
| abstract: |
|
RATIONALE: There is increasing interest regarding asthma heterogeneity in relation to inflammatory patterns. OBJECTIVES: To assess phenotypic characteristics, in particular clinical presentation of the disease, in 381 well-characterised adults with asthma from the French Epidemiological study on the Genetics and Environment of Asthma (EGEA) according to their blood inflammatory pattern. METHODS: Four blood inflammatory patterns were defined according to eosinophil (EOS) and neutrophil (NEU) count cut-off points. Samples with > or =250 EOS/mm(3) were classified as EOS(hi) and those with > or =5000 NEU/mm(3) as NEU(hi). Clinical characteristics include typical asthma and chronic obstructive pulmonary disease (COPD)-like symptoms, as well as composite quantitative scores addressing the activity of the disease. RESULTS: A substantial number of those with asthma (56.2%) had the EOS(lo) pattern (<250 EOS/mm(3)). Patients with asthma who had the EOS(hi) pattern had higher immunoglobulin E (IgE), a lower forced expiratory volume in 1 s (FEV(1)) and presented a more active asthma than those with the EOS(lo) pattern. Among those with the EOS(lo) pattern, neutrophil inflammation (NEU(hi)) was related to a less frequent positive skin prick test response (OR 0.44, 95% CI 0.20 to 0.96). Among those with the EOS(hi) pattern, neutrophil inflammation did not explain current asthma or asthma activity, and was significantly related to nocturnal symptoms (OR 5.21, 95% CI 1.44 to 18.8) independently of age, sex, smoking and inhaled corticosteroid treatment. In non-smokers with asthma, COPD-like symptoms, in particular chronic phlegm, were more frequent in those with neutrophil inflammation, independent of eosinophil inflammation (OR 2.35, 95% CI 1.08 to 5.10). CONCLUSIONS: Besides eosinophilia, neutrophil inflammation assessed in the blood is related to specific characteristics of asthma. Considering simultaneously neutrophilic and eosinophilic inflammation may contribute to help to disentangle this complex disease. |
|
| subject: |
|
Life Sciences/Health Care Sciences and Epidemiology
|
|
| fulltext language: |
|
English |
|
| ISSN: |
|
1468-3296 |
|
|
| publication format: |
|
Article in peer-reviewed journal |
|
| DOI: |
|
10.1136/thx.2008.103069 |
|
| journal: |
|
| Thorax (Thorax) |
| Publisher |
BMJ Publishing Group |
| ISSN |
0040-6376 |
|
|
| Audience: |
|
international |
|
| publication date: |
|
2009-05 |
|
| submission date: |
|
2009-01-08 |
|
| volume: |
|
64 |
|
| issue: |
|
5 |
|
| page, identifiant, ...: |
|
374-80 |
|
|
| keyword(s) of author: |
|
eosinophil – neutrophil – signs and symptoms – respiratory. |
|
| MeSH Descriptor(s): |
|
Adult – Age Factors – Asthma – Bronchitis – Chronic Disease – Cough – Eosinophils – Female – Humans – Leukocyte Count – Male – Neutrophils – Phenotype – Pulmonary Disease – Chronic Obstructive – Pulmonary Eosinophilia – Sex Factors – Young Adult |
|
| comment: |
|
Word count: 3032. |
|
| contract, financing: |
|
GA2LEN project, Global Allergy and Asthma European Network. |
|
| ANR Project: |
|
| Project Id |
ANR 05-SEST-020- 02/05-9-97, ANR-06-CEBS |
|
|
