T2-high asthma phenotypes across lifespan

Maison, Nicole; Omony, Jimmy; Illi, Sabina; Thiele, Dominik; Skevaki, Chrysanthi; Dittrich, Anna -Maria; Bahmer, Thomas; Rabe, Klaus Friedrich; Weckmann, Markus; Happle, Christine; Schaub, Bianca; Meyer, Meike; Foth, Svenja; Rietschel, Ernst; Renz, Harald; Hansen, Gesine; Kopp, Matthias Volkmar; Mutius, Erika von und Grychtol, Ruth (2022): T2-high asthma phenotypes across lifespan. In: European Respiratory Journal, Bd. 60, Nr. 3, 2102288

Abstract

Rationale In adults, personalised asthma treatment targets patients with type 2 (T2)-high and eosinophilic asthma phenotypes. It is unclear whether such classification is achievable in children. Objectives To define T2-high asthma with easily accessible biomarkers and compare resulting phenotypes across all ages. Methods In the multicentre clinical All Age Asthma Cohort (ALLIANCE), 1125 participants (n=776 asthmatics, n=349 controls) were recruited and followed for 2 years (1 year in adults). Extensive clinical characterisation (questionnaires, blood differential count, allergy testing, lung function and sputum induction (in adults)) was performed at baseline and follow-ups. Interleukin (IL)-4, IL-5 and IL-13 were measured after stimulation of whole blood with lipopolysaccharide (LPS) or anti-CD3/CD28.Measurements and main results Based on blood eosinophil counts and allergen-specific serum IgE antibodies, patients were categorised into four mutually exclusive phenotypes: atopy-only, eosinophils-only, T2-high (eosinophilia + atopy) and T2-low (neither eosinophilia nor atopy). The T2-high phenotype was found across all ages, even in very young children in whom it persisted to a large degree even after 2 years of follow-up. T2-high asthma in adults was associated with childhood onset, suggesting early origins of this asthma phenotype. In both children and adults, the T2-high phenotype was characterised by excessive production of specific IgE to allergens (p<0.0001) and, from school age onwards, by increased production of IL-5 after anti-CD3/CD28 stimulation of whole blood. Conclusions Using easily accessible biomarkers, patients with T2-high asthma can be identified across all ages delineating a distinct phenotype. These patients may benefit from therapy with biologicals even at a younger age.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0903-1936
• Sprache: Englisch