Severe exacerbations in moderate-to-severe asthmatics are associated with increased pro-inflammatory and type 1 mediators in sputum and serum

BMC Pulmonary Medicine
Michael A GhebreChris E Brightling

Abstract

Asthma is a heterogeneous disease and understanding this heterogeneity will enable the realisation of precision medicine. We sought to compare the sputum and serum inflammatory profiles in moderate-to-severe asthma during stable disease and exacerbation events. We recruited 102 adults and 34 children with asthma. The adults were assessed at baseline, 3, 6, and 12-month follow-up visits. Thirty-seven subjects were assessed at onset of severe exacerbation. Forty sputum mediators and 43 serum mediators were measured. Receiver-operator characteristic (ROC) curves were constructed to identify mediators that distinguish between stable disease and exacerbation events. The strongest discriminating sputum mediators in the adults were validated in the children. The mediators that were significantly increased at exacerbations versus stable disease and by ≥1.5-fold were sputum IL-1β, IL-6, IL-6R, IL-18, CXCL9, CXCL10, CCL5, TNFα, TNF-R1, TNF-R2, and CHTR and serum CXCL11. No mediators decreased ≥1.5-fold at exacerbation. The strongest discriminators of an exacerbation in adults (ROC area under the curve [AUC]) were sputum TNF-R2 0.69 (95% CI: 0.60 to 0.78) and IL-6R 0.68 (95% CI: 0.58 to 0.78). Sputum TNF-R2 and IL-6R were also discriminat...Continue Reading

References

Apr 1, 1995·The Journal of Allergy and Clinical Immunology·J V FahyH A Boushey
May 1, 1995·American Journal of Respiratory and Critical Care Medicine·A YokoyamaK Hiwada
May 1, 1997·American Journal of Respiratory and Critical Care Medicine·M M PizzichiniF E Hargreave
Dec 31, 1997·American Journal of Respiratory and Critical Care Medicine·A YokoyamaK Hiwada
Oct 14, 1998·American Journal of Respiratory and Critical Care Medicine·M M PizzichiniF E Hargreave
Feb 2, 1999·American Journal of Respiratory and Critical Care Medicine·I Tillie-LeblondP Gosset
Mar 11, 2000·American Journal of Respiratory and Critical Care Medicine·M Z NorzilaP G Gibson
Apr 11, 2000·The Journal of Allergy and Clinical Immunology·D E ParryJ E Gern
Sep 3, 2005·Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas·M B DaldeganA Talvani
Feb 17, 2006·The New England Journal of Medicine·Mike A BerryIan D Pavord
May 19, 2006·Journal of Leukocyte Biology·Stefan Rose-JohnSimon A Jones
Jul 14, 2007·The Journal of Allergy and Clinical Immunology·Peter A B WarkDonna E Davies
Nov 27, 2007·The Journal of Allergy and Clinical Immunology·Christopher BrightlingYassine Amrani
May 16, 2008·American Journal of Respiratory and Critical Care Medicine·Pranab HaldarRuth H Green
Jan 13, 2009·American Journal of Respiratory and Critical Care Medicine·Sally E WenzelUNKNOWN T03 Asthma Investigators
Jun 2, 2009·American Journal of Respiratory and Critical Care Medicine·Prescott G WoodruffJohn V Fahy
Jun 23, 2009·Inflammation Research : Official Journal of the European Histamine Research Society ... [et Al.]·Katalin EderAndras K Fulop
Oct 20, 2009·Chest·Jennifer K QuintJadwiga A Wedzicha
Oct 19, 2010·The Journal of Rheumatology·Jasvinder A SinghMaria Angeles Lopez-Olivo
Jun 18, 2011·American Journal of Respiratory and Critical Care Medicine·Mona BafadhelChristopher E Brightling
Sep 13, 2011·Lancet·Manuel A R FerreiraUNKNOWN Australian Asthma Genetics Consortium
Sep 14, 2011·Respiration; International Review of Thoracic Diseases·M BafadhelC E Brightling
May 5, 2012·The Journal of Allergy and Clinical Immunology·Gregory A HawkinsUNKNOWN National Heart, Lung, and Blood Institute–sponsored Severe Asthma Research Program (SARP)
Mar 26, 2013·Respirology : Official Journal of the Asian Pacific Society of Respirology·Geoffrey WarwickDeborah H Yates
Dec 18, 2013·The European Respiratory Journal·Kian Fan ChungW Gerald Teague
Mar 5, 2014·The Journal of Allergy and Clinical Immunology·Wei WuSally E Wenzel
Aug 19, 2014·The Journal of Allergy and Clinical Immunology·Michael A GhebreChris E Brightling
Oct 3, 2014·Science Translational Medicine·Janine BealeNathan W Bartlett
Oct 29, 2014·American Journal of Respiratory and Critical Care Medicine·David J JacksonSebastian L Johnston
Jun 11, 2016·The Lancet. Respiratory Medicine·Michael C PetersUNKNOWN National Heart, Lung, and Blood Institute Severe Asthma Research Program
Sep 23, 2016·JAMA Internal Medicine·Sebastian L JohnstonUNKNOWN AZALEA Trial Team
Dec 24, 2017·Lancet·Alberto PapiHelen K Reddel

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Citations

Jan 21, 2021·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·Stephane EsnaultNizar N Jarjour
Jan 19, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Freda YangUNKNOWN UK Severe Asthma Registry
Feb 6, 2021·American Journal of Respiratory and Critical Care Medicine·Annette T HastieEugene R Bleecker
May 16, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Yu Lai YuanBrian G Oliver
Jun 9, 2021·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·Johanna HuomanMaria C Jenmalm
Aug 23, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Nicola A HananiaBradley E Chipps
Nov 10, 2021·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Hanan M OsmanMariam Onsy F Hanna
Nov 14, 2021·Acta Paediatrica·Manisha RamphulErol A Gaillard

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Methods Mentioned

BETA
enzyme-linked immunosorbent assay

Software Mentioned

GraphPad
STATA
Prism
IC

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