Neutrophilic inflammation in sputum or blood does not define a clinically distinct asthma phenotype in ATLANTIS

Introduction Neutrophilic asthma has been suggested to be a clinically distinct phenotype characterised by more severe airflow obstruction and higher exacerbation risk. However, this has only been assessed in few and smaller studies, using different cut-offs to define neutrophilia, and with conflict...

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Main Authors: Pauline J.M. Kuks, Tessa M. Kole, Monica Kraft, Salman Siddiqui, Leonardo M. Fabbri, Klaus F. Rabe, Alberto Papi, Chris Brightling, Dave Singh, Thys van der Molen, Jan Willem W.H. Kocks, Kian Fan Chung, Ian M. Adcock, Pankaj K. Bhavsar, Nazanin Zounemat Kermani, Irene H. Heijink, Simon D. Pouwels, Huib A.M. Kerstjens, Dirk-Jan Slebos, Maarten van den Berge
Format: Article
Language:English
Published: European Respiratory Society 2025-02-01
Series:ERJ Open Research
Online Access:http://openres.ersjournals.com/content/11/1/00616-2024.full
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author Pauline J.M. Kuks
Tessa M. Kole
Monica Kraft
Salman Siddiqui
Leonardo M. Fabbri
Klaus F. Rabe
Alberto Papi
Chris Brightling
Dave Singh
Thys van der Molen
Jan Willem W.H. Kocks
Kian Fan Chung
Ian M. Adcock
Pankaj K. Bhavsar
Nazanin Zounemat Kermani
Irene H. Heijink
Simon D. Pouwels
Huib A.M. Kerstjens
Dirk-Jan Slebos
Maarten van den Berge
author_facet Pauline J.M. Kuks
Tessa M. Kole
Monica Kraft
Salman Siddiqui
Leonardo M. Fabbri
Klaus F. Rabe
Alberto Papi
Chris Brightling
Dave Singh
Thys van der Molen
Jan Willem W.H. Kocks
Kian Fan Chung
Ian M. Adcock
Pankaj K. Bhavsar
Nazanin Zounemat Kermani
Irene H. Heijink
Simon D. Pouwels
Huib A.M. Kerstjens
Dirk-Jan Slebos
Maarten van den Berge
author_sort Pauline J.M. Kuks
collection DOAJ
description Introduction Neutrophilic asthma has been suggested to be a clinically distinct phenotype characterised by more severe airflow obstruction and higher exacerbation risk. However, this has only been assessed in few and smaller studies, using different cut-offs to define neutrophilia, and with conflicting results. We used data from ATLANTIS, an observational longitudinal study including a large number of patients with asthma and healthy controls. The aim of the present study was to examine whether neutrophilic inflammation, either in sputum or blood, is more prevalent in asthma and whether it correlates with disease severity. Methods ATLANTIS included 773 asthma patients, with blood collected from 767 (99%) and sputum from 228 patients (30%). Data were available from 244 healthy controls, all providing blood and 126 (52%) providing sputum. Asthma patients were characterised, including parameters of large and small airways disease at baseline and after 6 and 12 months of follow-up. Sputum and blood neutrophilia were defined as values exceeding the upper quartile in asthma patients. Results The prevalence of sputum neutrophilia did not differ between asthma patients and healthy controls. Asthma patients with sputum neutrophilia did not display more severe symptoms, large or small airways disease or more frequent exacerbations. Blood neutrophilia was more common in asthma and was associated with higher body mass index, female sex, current smoking and systemic corticosteroid use. Patients with blood neutrophilia had a statistically significant, but small, increase in residual volume/total lung capacity. Blood neutrophilia was not associated with large or small airways disease or exacerbation risk. Conclusion Sputum and blood neutrophilia do not define a distinct clinical phenotype in asthma.
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spelling doaj-art-9966de91aec3402c897bbf96f038bf0e2025-08-20T03:02:17ZengEuropean Respiratory SocietyERJ Open Research2312-05412025-02-0111110.1183/23120541.00616-202400616-2024Neutrophilic inflammation in sputum or blood does not define a clinically distinct asthma phenotype in ATLANTISPauline J.M. Kuks0Tessa M. Kole1Monica Kraft2Salman Siddiqui3Leonardo M. Fabbri4Klaus F. Rabe5Alberto Papi6Chris Brightling7Dave Singh8Thys van der Molen9Jan Willem W.H. Kocks10Kian Fan Chung11Ian M. Adcock12Pankaj K. Bhavsar13Nazanin Zounemat Kermani14Irene H. Heijink15Simon D. Pouwels16Huib A.M. Kerstjens17Dirk-Jan Slebos18Maarten van den Berge19 Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA National Heart and Lung Institute, Imperial College London, London, UK Section of Respiratory Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy Dept of Medicine, Christian Albrechts University Kiel (member of the German Center for Lung Research (DZL)), Kiel, Germany Research Centre on Asthma and COPD, University of Ferrara, Ferrara, Italy Institute for Lung Health, National Institute for Health Research Biomedical Research Centre, University of Leicester, Leicester, UK Centre for Respiratory Medicine and Allergy, University Hospital of South Manchester, University of Manchester, Manchester, UK Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands National Heart and Lung Institute, Imperial College London, London, UK National Heart and Lung Institute, Imperial College London, London, UK National Heart and Lung Institute, Imperial College London, London, UK National Heart and Lung Institute, Imperial College London, London, UK Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Introduction Neutrophilic asthma has been suggested to be a clinically distinct phenotype characterised by more severe airflow obstruction and higher exacerbation risk. However, this has only been assessed in few and smaller studies, using different cut-offs to define neutrophilia, and with conflicting results. We used data from ATLANTIS, an observational longitudinal study including a large number of patients with asthma and healthy controls. The aim of the present study was to examine whether neutrophilic inflammation, either in sputum or blood, is more prevalent in asthma and whether it correlates with disease severity. Methods ATLANTIS included 773 asthma patients, with blood collected from 767 (99%) and sputum from 228 patients (30%). Data were available from 244 healthy controls, all providing blood and 126 (52%) providing sputum. Asthma patients were characterised, including parameters of large and small airways disease at baseline and after 6 and 12 months of follow-up. Sputum and blood neutrophilia were defined as values exceeding the upper quartile in asthma patients. Results The prevalence of sputum neutrophilia did not differ between asthma patients and healthy controls. Asthma patients with sputum neutrophilia did not display more severe symptoms, large or small airways disease or more frequent exacerbations. Blood neutrophilia was more common in asthma and was associated with higher body mass index, female sex, current smoking and systemic corticosteroid use. Patients with blood neutrophilia had a statistically significant, but small, increase in residual volume/total lung capacity. Blood neutrophilia was not associated with large or small airways disease or exacerbation risk. Conclusion Sputum and blood neutrophilia do not define a distinct clinical phenotype in asthma.http://openres.ersjournals.com/content/11/1/00616-2024.full
spellingShingle Pauline J.M. Kuks
Tessa M. Kole
Monica Kraft
Salman Siddiqui
Leonardo M. Fabbri
Klaus F. Rabe
Alberto Papi
Chris Brightling
Dave Singh
Thys van der Molen
Jan Willem W.H. Kocks
Kian Fan Chung
Ian M. Adcock
Pankaj K. Bhavsar
Nazanin Zounemat Kermani
Irene H. Heijink
Simon D. Pouwels
Huib A.M. Kerstjens
Dirk-Jan Slebos
Maarten van den Berge
Neutrophilic inflammation in sputum or blood does not define a clinically distinct asthma phenotype in ATLANTIS
ERJ Open Research
title Neutrophilic inflammation in sputum or blood does not define a clinically distinct asthma phenotype in ATLANTIS
title_full Neutrophilic inflammation in sputum or blood does not define a clinically distinct asthma phenotype in ATLANTIS
title_fullStr Neutrophilic inflammation in sputum or blood does not define a clinically distinct asthma phenotype in ATLANTIS
title_full_unstemmed Neutrophilic inflammation in sputum or blood does not define a clinically distinct asthma phenotype in ATLANTIS
title_short Neutrophilic inflammation in sputum or blood does not define a clinically distinct asthma phenotype in ATLANTIS
title_sort neutrophilic inflammation in sputum or blood does not define a clinically distinct asthma phenotype in atlantis
url http://openres.ersjournals.com/content/11/1/00616-2024.full
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