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Introduction: The study of induced sputum cellularity (ISC) allows setting up phenotypes in asthmatic patients who may present evolution and different responses to inhaled corticosteroids (IC). Patients with larger eosinophilia react better to IC, while neutrophilic phenotype is tied to more frequent exacerbations. Aims: To evaluate patients with bronchial asthma (BA) followed in medical consultations, clinical and functional and swelling characteristics, according to ISC and evolution after one year of following up. Methods: We included 47 patients (25 men) diagnosed of BA and with no previous treatment. Functional tests were performed baseline and annually: including FeNO, ACT, and treatment accomplished we assessed on the second visit one year later. According cell counts four phenotypes were identified: eosinophilic (Eos) counting E ≥2% y N Results: According to the analysis of ISC, we obtained 10 people with phenotype Eos, 11 Neu, 12 Mix and 14 Pau. On the first visit the neutrophilic group related greater number of exacerbations, FeNO levels was higher in eosinophilic and mixed groups, and ACT was lower in eosinophilic ones. Higher doses of IC were used in the neutrophilic group and we performed increased asthma control and decrease FeNO in the eosinophilic group. Conclusions: Patients with neutrophilic phenotype have more exacerbations and eosinophilic patients react better to treatment. After optimal treatment the evolution is similar in all groups. |
