Complex association patterns for inflammatory mediators in induced sputum from subjects with asthma

Hastie, Annette T.; Steele, Chad; Dunaway, Chad W.; Moore, Wendy C.; Rector, Brian; Ampleford, Elizabeth J.; Li, H.; Denlinger, Loren C.; Jarjour, Nizar N.; Meyers, Deborah A.; Bleecker, Eugene R.

doi:10.1111/cea.13129

Cited by 55 publications

(50 citation statements)

References 43 publications

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“…Several studies have reported increased eosinophils and/or neutrophils associated with severe asthma, although different cut‐offs for the definition of increased levels were used in these studies; and in line with previous findings, we found eosinophilia to be more common than neutrophilia. However, while blood neutrophils significantly separated severe asthma from other asthma in our study, blood eosinophils only tended to do so.…”

Section: Discussionmentioning

confidence: 99%

Severe asthma—A population study perspective

Bäckman

Jansson

Stridsman

et al. 2019

Clin Experimental Allergy

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Summary Background Severe asthma is a considerable challenge for patients, health‐care professionals and society. Few studies have estimated the prevalence of severe asthma according to modern definitions of which none based on a population study. Objective To describe characteristics and estimate the prevalence of severe asthma in a large adult population‐based asthma cohort followed for 10‐28 years. Methods N = 1006 subjects with asthma participated in a follow‐up during 2012‐14, when 830 (mean age 59 years, 56% women) still had current asthma. Severe asthma was defined according to three internationally well‐known criteria: the ATS workshop definition from 2000 used in the US Severe Asthma Research Programme (SARP), the 2014 ATS/ERS Task force definition and the GINA 2017. All subjects with severe asthma according to any of these criteria were undergoing respiratory specialist care and were also contacted by telephone to verify treatment adherence. Results The prevalence of severe asthma according to the three definitions was 3.6% (US SARP), 4.8% (ERS/ATS Taskforce), and 6.1% (GINA) among subjects with current asthma. Although all were using high ICS doses and other maintenance treatment, >90% did not have controlled asthma according to the asthma control test. Severe asthma was related to age >50 years, nasal polyposis, impaired lung function, sensitization to aspergillus, and tended to be more common in women. Further, neutrophils in blood significantly discriminated severe asthma from other asthma. Conclusions and Clinical Relevance Severe asthma differed significantly from other asthma in terms of demographic, clinical and inflammatory characteristics, results suggesting possibilities for improved treatment regimens of severe asthma. The prevalence of severe asthma in this asthma cohort was 4%‐6%, corresponding to approximately 0.5% of the general population.

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Section: Discussionmentioning

confidence: 99%

Severe asthma—A population study perspective

Bäckman

Jansson

Stridsman

et al. 2019

Clin Experimental Allergy

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“…For example, both low type 2 and high type 2 inflammatory conditions augment hyperresponsiveness. However, the complexity of inflammatory processes causing airway changes in asthma remains a challenge [17,18]. LMW toluene diisocyanate (TDI; 174.2 g/mol) is one of the most common causes of OA worldwide.…”

Section: Discussionmentioning

confidence: 99%

Asthma Case Cluster during Renovation of a Water-Damaged and Toxic Building

Hyvönen¹,

Syrjälä

2019

Microorganisms

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Background: An association between fungal exposure at work and asthma onset has been shown, but a causal relationship between them has not beTanle en established. Methods: The study describes an asthma cluster in workers in a building under renovation. Before renovation the work site had significant water damage, technical deficiencies, and ventilation problems. Worker protection was insufficient during renovation. In the building, toxicity was determined from dust as well as from cultured dust. Toxicity analysis was conducted in vitro using the boar spermatozoa motility assay. Results: During the 8-month renovation period, among 290 workers, 21 (7.2%) experienced new-onset asthma (9 women, 42.9%; 12 men, 57.1%; median age, 43 years (range, 30–60 years)). At the renovation site, they had been exposed to areas where remarkable toxicity was demonstrated in vitro. One year later, 13 (61.9%) of them still had moderate disease, and three (14.8%) had severe disease. Most patients had a poor response to inhaled corticosteroids. Conclusions: This study documents a clear temporal association between occupational exposure during renovation of a water-damaged building and a cluster of 21 new occupational asthma cases. In addition, dust and cultured dust from their work spaces showed remarkable toxicity based on inhibition of boar sperm motility in vitro.

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“…Subjects, sputum induction and processing, and Luminex analysis. Patients with mild to severe asthma were comprehensively characterized according to the NHLBI SARP phenotype protocol at Wake Forest School of Medicine as previously described (58), and a description of this cohort was recently reported (59). The sputum induction method was adopted from the NHLBI Asthma Clinical Research Network and used in SARP (60).…”

Section: Methodsmentioning

confidence: 99%