TY - JOUR
T1 - "T2-high" in severe asthma related to blood eosinophil, exhaled nitric oxide and serum periostin
AU - on behalf of the U-BIOPRED Study Group
AU - Pavlidis, Stelios
AU - Takahashi, Kentaro
AU - Ng Kee Kwong, Francois
AU - Xie, Jiaxing
AU - Hoda, Uruj
AU - Sun, Kai
AU - Elyasigomari, Vahid
AU - Agapow, Paul
AU - Loza, Matthew
AU - Baribaud, Fred
AU - Chanez, Pascal
AU - Fowler, Steve J.
AU - Shaw, Dominic E.
AU - Fleming, Louise J.
AU - Howarth, Peter H.
AU - Sousa, Ana R.
AU - Corfield, Julie
AU - Auffray, Charles
AU - de Meulder, Bertrand
AU - Knowles, Richard
AU - Sterk, Peter J.
AU - Guo, Yike
AU - Adcock, Ian M.
AU - Djukanovic, Ratko
AU - Fan Chung, Kian
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Type-2 (T2) immune responses in airway epithelial cells (AECs) classifies mild-moderate asthma into a T2-high phenotype. We examined whether currently available clinical biomarkers can predict AEC-defined T2-high phenotype within the U-BIOPRED cohort.The transcriptomic profile of AECs obtained from brushings of 103 patients with asthma and 44 healthy controls was obtained and gene set variation analysis used to determine the relative expression score of T2 asthma using a signature from interleukin (IL)-13-exposed AECs.37% of asthmatics (45% nonsmoking severe asthma, n=49; 33% of smoking or ex-smoking severe asthma, n=18; and 28% mild-moderate asthma, n=36) were T2-high using AEC gene expression. They were more symptomatic with higher exhaled nitric oxide fraction (FeNO) and blood and sputum eosinophils, but not serum IgE or periostin. Sputum eosinophilia correlated best with the T2-high signature. FeNO (≥30 ppb) and blood eosinophils (≥300 cells·µL-1) gave a moderate prediction of T2-high asthma. Sputum IL-4, IL-5 and IL-13 protein levels did not correlate with gene expression.T2-high severe asthma can be predicted to some extent from raised levels of FeNO, blood and sputum eosinophil counts, but serum IgE or serum periostin were poor predictors. Better bedside biomarkers are needed to detect T2-high.
AB - Type-2 (T2) immune responses in airway epithelial cells (AECs) classifies mild-moderate asthma into a T2-high phenotype. We examined whether currently available clinical biomarkers can predict AEC-defined T2-high phenotype within the U-BIOPRED cohort.The transcriptomic profile of AECs obtained from brushings of 103 patients with asthma and 44 healthy controls was obtained and gene set variation analysis used to determine the relative expression score of T2 asthma using a signature from interleukin (IL)-13-exposed AECs.37% of asthmatics (45% nonsmoking severe asthma, n=49; 33% of smoking or ex-smoking severe asthma, n=18; and 28% mild-moderate asthma, n=36) were T2-high using AEC gene expression. They were more symptomatic with higher exhaled nitric oxide fraction (FeNO) and blood and sputum eosinophils, but not serum IgE or periostin. Sputum eosinophilia correlated best with the T2-high signature. FeNO (≥30 ppb) and blood eosinophils (≥300 cells·µL-1) gave a moderate prediction of T2-high asthma. Sputum IL-4, IL-5 and IL-13 protein levels did not correlate with gene expression.T2-high severe asthma can be predicted to some extent from raised levels of FeNO, blood and sputum eosinophil counts, but serum IgE or serum periostin were poor predictors. Better bedside biomarkers are needed to detect T2-high.
UR - http://www.scopus.com/inward/record.url?scp=85059497954&partnerID=8YFLogxK
U2 - https://doi.org/10.1183/13993003.00938-2018
DO - https://doi.org/10.1183/13993003.00938-2018
M3 - Article
C2 - 30578390
SN - 0903-1936
VL - 53
JO - European respiratory journal
JF - European respiratory journal
IS - 1
M1 - 1800938
ER -