“T2-high” in severe asthma related to blood eosinophil, exhaled nitric oxide and serum periostin
Pavlidis, Stelios; Takahashi, Kentaro; Ng Kee Kwong, Francois; Xie, Jiaxing; Hoda, Uruj; Sun, Kai; Elyasigomari, Vahid; Agapow, Paul; Loza, Matthew; Baribaud, Fred; Chanez, Pascal; Fowler, Steve J.; Shaw, Dominic E.; Fleming, Louise J.; Howarth, Peter H.; Sousa, Ana R.; Corfield, Julie; Auffray, Charles; De Meulder, Bertrand; Knowles, Richard; Sterk, Peter J.; Guo, Yike; Adcock, Ian M.; Djukanovic, Ratko; Fan Chung, Kian
Francois Ng Kee Kwong
Steve J. Fowler
Professor DOMINICK SHAW email@example.com
Professor of Respiratory Medicine
Louise J. Fleming
Peter H. Howarth
Ana R. Sousa
Bertrand De Meulder
Peter J. Sterk
Ian M. Adcock
Kian Fan Chung
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.
|Journal Article Type||Article|
|Publication Date||Jan 3, 2019|
|Journal||European Respiratory Journal|
|Publisher||European Respiratory Society|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||Pavlidis, S., Takahashi, K., Ng Kee Kwong, F., Xie, J., Hoda, U., Sun, K., …Fan Chung, K. (2019). “T2-high” in severe asthma related to blood eosinophil, exhaled nitric oxide and serum periostin. European Respiratory Journal, 53(1), https://doi.org/10.1183/13993003.00938-2018|
|Keywords||Pulmonary and Respiratory Medicine|
|Additional Information||Stelios Pavlidis, Kentaro Takahashi, Francois Ng Kee Kwong, Jiaxing Xie, Uruj Hoda, Kai Sun, Vahid Elyasigomari, Paul Agapow, Matthew Loza, Fred Baribaud, Pascal Chanez, Steve J. Fowler, Dominic E. Shaw, Louise J. Fleming, Peter H. Howarth, Ana R. Sousa, Julie Corfield, Charles Auffray, Bertrand De Meulder, Richard Knowles, Peter J. Sterk, Yike Guo, Ian M. Adcock, Ratko Djukanovic, Kian Fan Chung, “T2-high” in severe asthma related to blood eosinophil, exhaled nitric oxide and serum periostin, European Respiratory Journal, Jan 2019, 53 (1) 1800938; DOI: 10.1183/13993003.00938-2018|