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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European Respiratory Society
2025-02-01
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| 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. |
| format | Article |
| id | doaj-art-9966de91aec3402c897bbf96f038bf0e |
| institution | DOAJ |
| issn | 2312-0541 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| 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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