Unraveling the conundrum of asthma phenotypes and endotypes

Bellanti, Joseph A.; Settipane, Russell A.

doi:10.2500/aap.2018.39.4112

Cited by 4 publications

(1 citation statement)

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“…Asthma is now being defined in terms of phenotypes and endotypes . Our everyday clinical practice supported by previous studies shows that NERD patients present a wide spectrum of disease course yet share common features as chronic rhinosinusitis and intolerance of aspirin and other COX‐1 inhibitors.…”

Section: Introductionmentioning

confidence: 93%

Subphenotypes of nonsteroidal antiinflammatory disease‐exacerbated respiratory disease identified by latent class analysis

Celejewska‐Wójcik

Wójcik

Ignacak-Popiel

et al. 2020

Allergy

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Background: Induced sputum (IS) allows to measure mediators of asthmatic inflammation in bronchial secretions. NSAID-exacerbated respiratory disease (NERD) is recognized as a distinct asthma phenotype, usually with a severe course, eosinophilic airway inflammation, and increased production of pro-inflammatory eicosanoids. A more insightful analysis of NERD patients has shown this phenotype to be nonhomogeneous. Objective:We aimed to identify possible subphenotypes in a cohort of NERD patients with the means of latent class analysis (LCA).Methods: A total of 95 asthma patients with aspirin hypersensitivity underwent sputum induction. High-performance liquid chromatography or gas chromatography coupled with mass spectrometry was used to profile eicosanoids in induced sputum supernatant (ISS). Sixteen variables covering clinical characteristics, IS inflammatory cells, and eicosanoids were considered in the LCA.Results: Three classes (subphenotypes) were distinguished within the NERD cohort.Class 1 subjects had mild-to-moderate asthma, an almost equal distribution of inflammatory cell patterns, the lowest concentrations of eicosanoids, and logLTE 4 /logPGE 2 ratio. Class 2 represented severe asthma with impaired lung function despite high doses of steroids. High sputum eosinophilia was in line with higher pro-inflammatory LTE 4 in ISS and the highest logLTE 4 /logPGE 2 ratio. Class 3 subjects had mild-to-moderate asthma and were also characterized by eosinophilic airway inflammation, yet increased production of pro-(LTE 4 , PGD 2 and 11-dehydro-TBX 2 ) was balanced by

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Section: Introductionmentioning

confidence: 93%