Identification of asthma clusters in two independent Korean adult asthma cohorts

Kim, Tae‐Bum; Jang, An Soo; Kwon, Hyung Wook; Park, Jong Suk; Chang, Yoon-Seok; Cho, Sang Heon; Choi, Byoung Whui; Park, Jung Won; Nam, Dong Ho; Yoon, Ho Joo; Cho, Young Joo; Moon, Hee Bom; Cho, You Sook; Park, Choon-Sik

doi:10.1183/09031936.00100811

Cited by 129 publications

(129 citation statements)

References 20 publications

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“…Proinflammatory cytokines and matrix metalloproteinases are increased in the lungs of these APN-deficient animals, and APN leads to TNF-a and matrix metalloproteinase-12 suppression (5). Consistent with the hypothesis of low or absent APN in the development of lung emphysema is the observation of endothelial dysfunction in the lungs of adiponectin-knockout mice and the amelioration of the emphysematous phenotype by APN supplementation in these animals, suggesting that APN may play a role in lung maintenance through sustaining endothelial survival (6). These animal data suggest that hypoadiponectinemia plays a critical role in the progression of these structural lung parenchymal changes and the important role of APN in lung maintenance.…”

supporting

confidence: 62%

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The Natural History of Asthma Phenotypes Identified by Cluster Analysis. Looking for Chutes and Ladders

Moore¹

2013

Am J Respir Crit Care Med

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Cluster analysis has greatly expanded our investigation of asthma phenotypes. These multivariate approaches explore the heterogeneity of asthma in a way hypothesis-driven univariate analyses cannot. Nearly all cluster analyses currently published, however, are cross-sectional glimpses of groups of patients as they look today without a preview of how they will look in the future (1-6). What is the natural disease progression of these new asthma phenotypes?A good analogy is to conceptualize asthma severity as a threedimensional labyrinth. Cross-sectional "cluster" phenotypes are different entry portals into the maze. Within the labyrinth, there are ladders that allow you to ascend to the upper level (improving asthma severity). Likewise, there are chutes that lead to the dungeon (worsening asthma severity). Many participants, however, stay on the same level, managing to sidestep the ladders and chutes (stable asthma severity). The question is whether the initial "entry" phenotype determines the journey through the labyrinth. Can a multivariate "cluster" phenotype warn of potential chutes or identify potential ladders? The article in this issue of the Journal by Boudier and colleagues (pp. 550-560) describes asthma phenotypes by cluster analysis at two time points 10 years apart (7). It is a glimpse into the natural history of complex asthma phenotypes and variability over time.

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supporting

confidence: 62%

“…In general, it is difficult to have both of these ideals. Thus, current asthma cluster analyses fall into two groups, large population studies with fewer variables or smaller cohorts with extensive variables (1)(2)(3)(4)(5)(6). The two approaches are complementary and each has merits as we explore asthma heterogeneity.…”

mentioning

confidence: 99%

The Natural History of Asthma Phenotypes Identified by Cluster Analysis. Looking for Chutes and Ladders

Moore¹

2013

Am J Respir Crit Care Med

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“…In addition to the two phenotypes with severe adult-onset asthma, a recent cluster analysis in 724 Korean patients with asthma also identified a milder adult-onset asthma phenotype [102]. This cluster covered one-third of the total asthma population and had the best lung function.…”

Section: Adult-onset Mild Asthmamentioning

confidence: 99%

Adult-onset asthma: is it really different?

Nijs¹,

Venekamp²,

Bel³

2013

European Respiratory Review

246

205

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Asthma that starts in adulthood differs from childhood-onset asthma in that it is often non-atopic, more severe and associated with a faster decline in lung function.Understanding of the underlying mechanism of adult-onset asthma and identification of specific phenotypes may further our understanding of pathophysiology and treatment response, leading to better targeting of both existing and new approaches for personalised management. Pivotal studies in past years have led to sustained progress in many areas, ranging from risk factors for development, identification of different phenotypes, and introduction of new therapies.This review highlights and discusses literature on adult-onset asthma, with special focus on the differences from childhood-onset asthma, risk factors for development, phenotypes of adultonset asthma and new approaches for personalised management.

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“…Frequent exacerbators are also a well-defined phenotype because of its major source of disease. Such clusters have been replicated in adult and paediatric cohorts in the Western world [24][25][26][27] as well as in Korean and Japanese cohorts 28,29 , with greater concordance in clusters related to severe asthma. Patients on high-dose inhaled corticosteroid therapy made up of clusters 4 and 5 of the adult SARP cohort, often taken together with oral corticosteroid treatment, are usually associated with severe airflow obstruction (Fig.…”

Section: Phenotyping Based On Clustering Of Clinical-physiological Datamentioning

confidence: 74%

Phenotyping Asthma: Linking Clinical Features to Biomolecular Pathways

Chung¹

2016

BRN

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Asthma presents in various clinical forms and levels of severity and has a complex pathophysiology. Unbiased clustering was initially performed on clinical features, but the addition of biomarkers such as sputum and blood cellular profiles has led to the description of several phenotypes and enabled the prediction of responses to targeted therapies. Clusters of severe asthma include those on high-dose corticosteroid treatment, often with both inhaled and oral treatment, associated with severe airflow obstruction. Concordance between symptoms and sputum eosinophilia is observed in an eosinophilic inflammation-predominant group with few symptoms and late-onset disease who have a high prevalence of rhinosinusitis, aspirin sensitivity, and exacerbations. Sputum or blood eosinophilia is also a biomarker that can predict therapeutic responses to antibody-based treatments to block the effects of the T-helper-2 cytokine, interleukin-5. Low T-helper-2 expression predicts poor therapeutic response to inhaled corticosteroid therapy. Much less is known about 'non-eosinophilic' or non-T-helper-2 asthma. Clustering on transcriptomic and/or proteomic data is leading to definition of molecular phenotypes and potential mechanisms. The definition of endotypes and biomarkers of disease and therapeutic responses will pave the way towards personalized medicine and healthcare for asthma. For the clinician, these will translate into useful tools and means for managing patients with asthma, particularly severe asthma. Corresponding author : Kian Fan Chung, f.chung@imperial.ac.uk

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Identification of asthma clusters in two independent Korean adult asthma cohorts

Cited by 129 publications

References 20 publications

The Natural History of Asthma Phenotypes Identified by Cluster Analysis. Looking for Chutes and Ladders

The Natural History of Asthma Phenotypes Identified by Cluster Analysis. Looking for Chutes and Ladders

Adult-onset asthma: is it really different?

Phenotyping Asthma: Linking Clinical Features to Biomolecular Pathways

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