The European Network For Understanding Mechanisms Of Severe Asthma study

To the Editor: We found the results of the European Network For Understanding Mechanisms Of Severe Asthma (ENFUMOSA) study 1 and its accompanying Editorial 2 very interesting and would like to raise two issues, one regarding classification of subjects, and the other concerning pathogenesis. The ENFUMOSA study defined a group with severe asthma, requiring high­dose inhaled corticosteroids who continued to experience severe exacerbations of asthma. These subjects differed from the comparison group by having less atopy and increased sputum neutrophils. It was hypothesised that other environmental factors, such as infections, may be important. We recently reviewed the inflammatory …