1. T2-high asthma phenotypes across lifespan
- Author
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Nicole, Maison, Jimmy, Omony, Sabina, Illi, Dominik, Thiele, Chrysanthi, Skevaki, Anna-Maria, Dittrich, Thomas, Bahmer, Klaus Friedrich, Rabe, Markus, Weckmann, Christine, Happle, Bianca, Schaub, Meike, Meyer, Svenja, Foth, Ernst, Rietschel, Harald, Renz, Gesine, Hansen, Matthias Volkmar, Kopp, Erika, von Mutius, Ruth, Grychtol, Oliver, Fuchs, Barbara, Roesler, Nils, Welchering, Naschla, Kohistani-Greif, Johanna, Kurz, Katja, Landgraf-Rauf, Kristina, Laubhahn, Claudia, Liebl, Markus, Ege, Alexander, Hose, Esther, Zeitlmann, Mira, Berbig, Carola, Marzi, Christina, Schauberger, Ulrich, Zissler, Carsten, Schmidt-Weber, Isabell, Ricklefs, Gesa, Diekmann, Lena, Liboschik, Gesche, Voigt, Laila, Sultansei, Gyde, Nissen, Inke R, König, Anne-Marie, Kirsten, Frauke, Pedersen, Henrik, Watz, Benjamin, Waschki, Christian, Herzmann, Mustafa, Abdo, Heike, Biller, Karoline I, Gaede, Xenia, Bovermann, Alena, Steinmetz, Berrit Liselotte, Husstedt, Catharina, Nitsche, Vera, Veith, Marlen, Szewczyk, Folke, Brinkmann, Aydin, Malik, Nicolaus, Schwerk, Christian, Dopfer, Mareike, Price, Adan Chari, Jirmo, Anika, Habener, David S, DeLuca, Svenja, Gaedcke, Bin, Liu, Mifflin-Rae, Calveron, Stefanie, Weber, Tom, Schildberg, Silke, van Koningsbruggen-Rietschel, and Miguel, Alcazar
- Subjects
Pulmonary and Respiratory Medicine ,Lipopolysaccharides ,Interleukin-13 ,Longevity ,Allergens ,Immunoglobulin E ,Asthma ,Eosinophils ,Phenotype ,CD28 Antigens ,Eosinophilia ,Humans ,Interleukin-5 ,Biomarkers - Abstract
RationaleIn adults, personalised asthma treatment targets patients with type 2 (T2)-high and eosinophilic asthma phenotypes. It is unclear whether such classification is achievable in children.ObjectivesTo define T2-high asthma with easily accessible biomarkers and compare resulting phenotypes across all ages.MethodsIn the multicentre clinical All Age Asthma Cohort (ALLIANCE), 1125 participants (n=776 asthmatics, n=349 controls) were recruited and followed for 2 years (1 year in adults). Extensive clinical characterisation (questionnaires, blood differential count, allergy testing, lung function and sputum induction (in adults)) was performed at baseline and follow-ups. Interleukin (IL)-4, IL-5 and IL-13 were measured after stimulation of whole blood with lipopolysaccharide (LPS) or anti-CD3/CD28.Measurements and main resultsBased on blood eosinophil counts and allergen-specific serum IgE antibodies, patients were categorised into four mutually exclusive phenotypes: “atopy-only”, “eosinophils-only”, “T2-high” (eosinophilia + atopy) and “T2-low” (neither eosinophilia nor atopy). The T2-high phenotype was found across all ages, even in very young children in whom it persisted to a large degree even after 2 years of follow-up. T2-high asthma in adults was associated with childhood onset, suggesting early origins of this asthma phenotype. In both children and adults, the T2-high phenotype was characterised by excessive production of specific IgE to allergens (pConclusionsUsing easily accessible biomarkers, patients with T2-high asthma can be identified across all ages delineating a distinct phenotype. These patients may benefit from therapy with biologicals even at a younger age.
- Published
- 2021