Journal
CLINICAL AND EXPERIMENTAL ALLERGY
Volume 45, Issue 12, Pages 1779-1789Publisher
WILEY
DOI: 10.1111/cea.12654
Keywords
asthma phenotype; eicosanoids; induced sputum; latent class analysis
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Funding
- Polish Ministry of Science [N402 593040]
- [PSPB-072/2010]
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Background Induced sputum (IS) allows to measure mediators of asthmatic inflammation in bronchial secretions. The specific role of induced sputum supernatant (ISS) endogenous bioactive lipid mediators in subtypes of asthma is not well understood. Objective To investigate the interactions between airway inflammation and clinical phenotypes of asthma, we integrated induced sputum supernatant (ISS) eicosanoids and quantitative assessment of infiltrating cells into new subtypes with the means of latent class analysis (LCA). Methods One hundred and thirty-nine asthmatics with and without aspirin hypersensitivity underwent sputum induction. High-performance liquid chromatography or gas chromatography coupled with mass spectrometry was used to profile eicosanoids. Nineteen variables covering clinical characteristics, IS inflammatory cells and eicosanoids were considered in the LCA. Results Four phenotypic asthma classes were distinguished. Class 1 with mild-to-moderate asthma, chronic rhinosinusitis (CRS), high PGA(2) in ISS and almost equal distribution of inflammation cell patterns. Class 3 subjects also had mild-to-moderate asthma but without upper airway symptoms. Induced sputum was often paucigranulocytic with low levels of lipid mediators. Classes 2 and 4 represented severe asthma with CRS and impaired lung function despite high doses of steroids. High blood and sputum eosinophilia was in line with high cysteinyl leukotrienes and PGD(2) in ISS only in class 2. Class 4 subjects tended to have increased sputum neutrophilia and PGE(2) in ISS. Aspirin hypersensitivity was most frequent among class 2 subjects. Conclusions & Clinical Relevance The LCA revealed four distinct asthma classes differing in eicosanoid pathways.
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