Journal
CLINICAL AND EXPERIMENTAL ALLERGY
Volume 48, Issue 9, Pages 1137-1146Publisher
WILEY
DOI: 10.1111/cea.13170
Keywords
asthma; biomarker; eosinophils; exacerbation; FeNO; pneumology
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Funding
- Ministry of Education, Culture, Sports, Science and Technology of Japan [24249049, 26461151]
- Japan Allergy Foundation
- AstraZeneca
- Kyorin
- Grants-in-Aid for Scientific Research [26461151] Funding Source: KAKEN
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BackgroundA predisposition to exacerbations is being recognized as a distinct phenotype with previous exacerbations representing the strongest clinical factor associated with future exacerbation. Thus, to identify additional novel biomarkers associated with asthma exacerbations, past exacerbation status must be included as a confounding factor. ObjectiveThis study aimed to characterize the clinical and biomarker features associated with asthma exacerbations in severe asthma. MethodsWe evaluated clinical parameters from 105 severe asthmatics yearly for 3years, as well as their exacerbation status. We classified the subjects into 3 groups: (i) consistent non-exacerbators (CNE, subjects who did not experience any exacerbation over the 3-year period); (ii) consistent frequent exacerbators (CFE, subjects with frequent exacerbation, defined as those who had 2 or more exacerbations within 1year, throughout the 3-year period); and (iii) intermittent exacerbators (IE). We conducted multivariate analysis for comparisons among the groups for multiple factors, including several Th2-related biomarkers, in addition to the past exacerbation status. ResultsThirty-nine subjects were classified as CNE, 15 as CFE, and 51 as IE. Frequent exacerbations in the previous year predicted exacerbations for the following year (P<.001). Among the several Th2-related biomarkers, only FeNO was associated with exacerbation status. When we analysed the data after the second visit, the impact of FeNO on predicting future exacerbation remained significant, even after considering the exacerbation status during the first year (P<.05). Conclusions and Clinical RelevanceMeasurement of FeNO has a significant potential to predict future asthma exacerbation, which is independent of the past exacerbation history.
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