Severe eosinophilic asthma in Chinese C‐BIOPRED asthma cohort

• Published in: Clinical and translational medicine Vol. 12; no. 2; pp. e710 - n/a
• Main Authors: Zhang, Qingling, Fu, Xiuhua, Wang, Changzheng, Shen, Huahao, Zhu, Lei, Shi, Guochao, Qiu, Zhongmin, Wen, Zhongguang, Gu, Wei, Luo, Wei, Zhao, Lina, Chen, Yunqin, Lim, Sam, Xiao, Chang, Kang, Jian, Zhang, Yunhui, Huang, Mao, Xu, Jinfu, Huang, Kewu, Li, Qiang, Zhang, Xiangyan, Zhao, Jianping, Liu, Xiaoxia, Sun, Shenghua, Tang, Huaping, He, Bei, Cai, Shaoxi, Chen, Ping, Wei, Chunhua, Wang, Guangfa, Xie, Lixin, Lin, Jiangtao, Tang, Yuling, Han, Zhihai, Chung, Kian Fan, Zhong, Nanshan
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.02.2022; John Wiley and Sons Inc; Wiley
• Subjects: Adult; Asthma; Asthma - classification; Asthma - diagnosis; Asthma - epidemiology; Biomarkers; blood eosinophil count; Body mass index; China - epidemiology; cigarette smoking; Cohort Studies; exacerbations; Female; fractional exhaled nitric oxide; Humans; Letter to Editor; Male; Middle Aged; Neutrophils; Pulmonary Eosinophilia - complications; Pulmonary Eosinophilia - diagnosis; Pulmonary Eosinophilia - epidemiology; Quality of life; Questionnaires; severe asthma; Steroids; Surveys and Questionnaires; China; cigarette smoking; severe asthma; blood eosinophil count; fractional exhaled nitric oxide; exacerbations
• ISSN: 2001-1326; 2001-1326
• DOI: 10.1002/ctm2.710

TABLE 1 Demographic characteristics of C-BIOPRED Characteristic Severe nonsmoking asthma (n = 342) Smokers and ex-smokers with severe asthma (n = 110) Mild/moderate nonsmoking asthma (n = 93) Healthy nonsmoking controls (n = 100) p-Value Gender Male 101 (29.5) 106 (96.4) 43 (46.2) 36 (36.0) <.001 Female 241 (70.5) 4 (3.6) 50 (53.8) 64 (64.0) Age (years) 53.39 ± 11.45 57.31 ± 9.46 48.65 ± 12.07 33.18 ± 14.20 <.001 Age of diagnosis (years) 40.08 ± 16.42 44.46 ± 17.36 35.76 ± 16.07 NA <.001 BMI (kg/m2) 24.31 ± 3.65 25.05 ± 3.25 24.21 ± 3.08 22.38 ± 2.81 <.001  BMI Normal (< 28) 293 (85.7) 90 (81.8) 84 (90.3) 98 (98.0) <.001  BMI Obesity (> = 28) 49 (14.3) 20 (18.2) 9 (9.7) 2 (2.0) Smoking (Pack-years) NA 28.71 (22.76) NA NA NA Current Smoker NA 44 (40.0) NA NA NA Ex-smoker NA 66 (60.0) NA NA NA pre-BD FVC, L 2.57 ± 0.76 3.11 ± 0.80 3.35 ± 0.94 3.81 ± 0.97 <.001 pre-BD FVC % pred, L 83.43 ± 17.38 80.76 ± 16.54 97.21 ± 17.54 101.50 ± 12.35 <.001 pre-BD FEV1, L 1.55 ± 0.58 1.79 ± 0.71 2.21 ± 0.81 3.20 ± 0.79 <.001 pre-BD FEV1% pred 64.79 ± 21.16 60.87 ± 21.22 81.69 ± 23.13 106.01 ± 11.44 <.001 pre-BD FEV1/FVC, % 60.17 ± 12.29 56.72 ± 12.43 65.38 ± 11.65 84.19 ± 5.83 <.001 Post-BD, n 329 108 80 Post-BD FEV1, L 1.82 ± 0.60 2.07 ± 0.72 2.45 ± 0.78 NA <.001 Post-BD FEV1% pred 76.02 ± 21.16 70.47 ± 21.93 91.03 ± 21.79 NA <.001 Post-BD FEV1 (% increase) 21.60 ± 15.45 17.88 ± 14.73 14.74±10.56 NA <.001 Exacerbations in prior year 1.50 ± 1.80 1.36 ± 1.60 0.33 ± 0.54 NA <.001 Exacerbation in the previous year, n(%) Yes 113 (33.0) 36(32.7) 64 (68.8) NA <.001 No 219 (64.0) 72 (65.5) 27 (29.0) NA Healthcare resource utilization, n(%) Yes 64 (18.7) 14 (12.7) 5 (5.4) NA <.001 No 278 (81.3) 96 (87.3) 88 (94.6) 100 (100.0) Abbreviations: BD, bronchodilator; BMI, body mass index; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; Max, maximum; Min, Minimum, N, number of subjects in the cohort, n, Number of subjects included in the analysis; NA, Not applicable; SD, Standard deviation. Regarding asthma treatments, the NSA and SSA groups, 9.94% of NSA and 12.73% of SSA received daily OCS, and those in the MMA group received none (Table S1). [...]severe asthma patients have more symptoms, more exacerbations, more airflow obstruction, and more nasal polyps even if they are on high-dose asthma medication regimens, including oral corticosteroids. Abbreviations: ECP, eosinophil cationic protein; FeNO, fractional level of nitric oxide in exhaled breath; HX2, house dust mix; MX2, mold mix; TX4, tree pollen mix; WX5, weed pollen mix; FX5, food allergens. To understand the role of inflammatory factors in severe asthma, we measured blood eosinophil and neutrophil counts (BEC and BNC) and fractional level of nitric oxide in exhaled breath (FeNO), and the level of granulocytes in sputum (SEC and SNC) collected after inhalation of hypertonic saline solutions in a smaller group (260 out of 545 asthma participants).