Overlap of allergic, eosinophilic and type 2 inflammatory subtypes in moderate-to-severe asthma.

Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology
Meng ChenEugene Choo

Abstract

Current biologic therapies target allergic, eosinophilic or type 2 inflammation phenotypic asthma. However, frequency and degree of overlap among these subtypes is unclear. To characterize overlap among allergic, eosinophilic and type 2 asthma phenotypes. Post hoc analyses of baseline data were performed in two adult populations: (a) not selected for any asthma subtype (N = 935) and (b) selected for allergic asthma (N = 1049). Degree of overlap was examined using commonly accepted phenotypic definitions to guide treatment for allergic asthma (skin prick-positive and/or positive serum-specific immunoglobulin E > 0.35 kU/L) and eosinophilic asthma (blood eosinophil high count ≥ 300 cells/µL; low cut-off ≥ 150 cells/µL). Consistent with previous studies, fractional exhaled nitric oxide high level of ≥ 35 ppb and low cut-off of ≥ 25 ppb were selected as local markers of type 2 inflammation and to prevent overlap with the systemic eosinophilic asthma definition. In the non-subtype-selected population, 78.0% had allergic asthma; of these, 39.5% had eosinophilic asthma and 29.5% had type 2 asthma. Within patients with eosinophilic asthma (40.6% of total), 75.8% had allergic asthma and 41.3% had type 2 asthma. Within patients with type...Continue Reading

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Mar 25, 2021·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·Mohamed H Shamji, Robert J Boyle

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