Lung function fluctuation patterns unveil asthma and COPD phenotypes unrelated to type 2 inflammation

Autor: Peter H. Howarth, Bianca Beghe, Nikos M. Siafakas, Guy Joos, Anna James, Edgar Delgado-Eckert, Junya Ono, Apostolos Bossios, Mark Gjomarkaj, Ewa Nizankowska-Mogilnicka, Alberto Papi, Delphine Meier-Girard, Peter J. Sterk, Urs Frey, Pascal Chanez, Lars I. Andersson, Maria Mikus, Sebastian L. Johnston, Mina Gaga, Kenji Izuhara, Elisabeth H. Bel, Roelinde Middelveld, Maciej Kupczyk, Klaus F. Rabe, Sven-Erik Dahlén, Barbro Dahlén
Přispěvatelé: Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Pulmonology, AII - Inflammatory diseases
Rok vydání: 2020
Předmět:
Zdroj: Journal of Allergy and Clinical Immunology
Journal of Allergy and Clinical Immunology, 2021, 148 (2), pp.407-419. ⟨10.1016/j.jaci.2020.12.652⟩
Journal of allergy and clinical immunology, 148(2), 407-419. Mosby Inc.
Journal of allergy and clinical immunology 148 (2021): 407–419. doi:10.1016/j.jaci.2020.12.652
info:cnr-pdr/source/autori:Delgado-Eckert E.; James A.; Meier-Girard D.; Kupczyk M.; Andersson L.I.; Bossios A.; Mikus M.; Ono J.; Izuhara K.; Middelveld R.; Dahlen B.; Gaga M.; Siafakas N.M.; Papi A.; Beghe B.; Joos G.; Rabe K.F.; Sterk P.J.; Bel E.H.; Johnston S.L.; Chanez P.; Gjomarkaj M.; Howarth P.H.; Nizankowska-Mogilnicka E.; Dahlen S.-E.; Frey U./titolo:Lung function fluctuation patterns unveil asthma and COPD phenotypes unrelated to type 2 inflammation/doi:10.1016%2Fj.jaci.2020.12.652/rivista:Journal of allergy and clinical immunology/anno:2021/pagina_da:407/pagina_a:419/intervallo_pagine:407–419/volume:148
ISSN: 1097-6825
0091-6749
DOI: 10.1016/j.jaci.2020.12.652⟩
Popis: Background In all chronic airway diseases, the dynamics of airway function are influenced by underlying airway inflammation and bronchial hyperresponsiveness along with limitations in reversibility owing to airway and lung remodeling as well as mucous plugging. The relative contribution of each component translates into specific clinical patterns of symptoms, quality of life, exacerbation risk, and treatment success. Objective We aimed to evaluate whether subgrouping of patients with obstructive airway diseases according to patterns of fluctuation in lung function allows identification of specific phenotypes with distinct clinical characteristics. Methods We applied the novel method of fluctuation-based clustering (FBC) to twice-daily FEV1 measurements recorded over a 1-year period in a mixed group of 134 adults with mild-to-moderate asthma, severe asthma, or chronic obstructive pulmonary disease from the European BIOAIR cohort. Results Independently of clinical diagnosis, FBC divided patients into 4 fluctuation-based clusters with progressively increasing alterations in lung function that corresponded to patterns of increasing clinical severity, risk of exacerbation, and lower quality of life. Clusters of patients with airway disease with significantly elevated levels of biomarkers relating to remodeling (osteonectin) and cellular senescence (plasminogen activator inhibitor-1), accompanied by a loss of airway reversibility, pulmonary hyperinflation, and loss of diffusion capacity, were identified. The 4 clusters generated were stable over time and revealed no differences in levels of markers of type 2 inflammation (blood eosinophils and periostin). Conclusion FBC-based phenotyping provides another level of information that is complementary to clinical diagnosis and unrelated to eosinophilic inflammation, which could identify patients who may benefit from specific treatment strategies or closer monitoring.
Databáze: OpenAIRE
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