PMID- 32553777
OWN - NLM
STAT- MEDLINE
DCOM- 20210201
LR  - 20210201
IS  - 1534-4436 (Electronic)
IS  - 1081-1206 (Linking)
VI  - 126
IP  - 1
DP  - 2021 Jan
TI  - Spontaneous sputum discriminates inflammatory phenotypes in patients with asthma.
PG  - 54-60.e1
LID - S1081-1206(20)30412-9 [pii]
LID - 10.1016/j.anai.2020.06.017 [doi]
AB  - BACKGROUND: Eosinophils in induced sputum are not only a useful biomarker for 
      diagnosing asthma but are also associated with severe asthma. However, little is 
      known about the association between eosinophils in spontaneous sputum and asthma 
      severity. OBJECTIVE: To investigate whether spontaneous sputum eosinophils are 
      related to severe asthma in adult patients with asthma. METHODS: We conducted a 
      retrospective cross-sectional study on 86 people with asthma whose spontaneous 
      sputa were successfully collected. Patients were classified into 4 phenotypes 
      according to the eosinophil and neutrophil levels in spontaneous sputum. We 
      determined the association between inflammatory phenotypes and severe asthma. 
      Moreover, we also compared asthma severity among the phenotypes classified 
      according to blood eosinophils and spontaneous sputum eosinophils. RESULTS: 
      Asthma phenotypes were as follows: paucigranulocytic, 30.2%; neutrophilic, 18.6%; 
      eosinophilic, 32.6%; and mixed, 18.6%. People with eosinophilic asthma had the 
      highest blood eosinophils, total immunoglobulin E (IgE), and fractional exhaled 
      nitric oxide among the 4 phenotypes. Significant differences were observed in 
      asthma severity between the phenotypes (P = .019). In particular, 57.2% and 56.2% 
      of patients had severe eosinophilic asthma and mixed asthma, respectively. The 
      logistic regression analysis revealed that spontaneous sputum eosinophilia 
      represented the strongest association with severe asthma among the inflammatory 
      variables. Finally, more patients with severe asthma were included in the 
      phenotype with spontaneous sputum eosinophils greater than 3% and blood 
      eosinophils less than or equal to 300/muL and in the phenotype with spontaneous 
      sputum eosinophils greater than 3% and blood eosinophils greater than 300/muL. 
      CONCLUSION: Spontaneous sputum can provide helpful information on airway 
      inflammatory phenotyping in patients with asthma.
CI  - Copyright (c) 2020 American College of Allergy, Asthma & Immunology. Published by 
      Elsevier Inc. All rights reserved.
FAU - Tanaka, Akihiko
AU  - Tanaka A
AD  - Division of Respiratory Medicine and Allergology, Department of Medicine, School 
      of Medicine, Showa University, Tokyo, Japan. Electronic address: 
      tanakaa@med.showa-u.ac.jp.
FAU - Sato, Hiroki
AU  - Sato H
AD  - Division of Respiratory Medicine and Allergology, Department of Medicine, School 
      of Medicine, Showa University, Tokyo, Japan.
FAU - Akimoto, Kaho
AU  - Akimoto K
AD  - Division of Respiratory Medicine and Allergology, Department of Medicine, School 
      of Medicine, Showa University, Tokyo, Japan.
FAU - Matsunaga, Tomohiro
AU  - Matsunaga T
AD  - Division of Respiratory Medicine and Allergology, Department of Medicine, School 
      of Medicine, Showa University, Tokyo, Japan.
FAU - Sagara, Hironori
AU  - Sagara H
AD  - Division of Respiratory Medicine and Allergology, Department of Medicine, School 
      of Medicine, Showa University, Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20200615
PL  - United States
TA  - Ann Allergy Asthma Immunol
JT  - Annals of allergy, asthma & immunology : official publication of the American 
      College of Allergy, Asthma, & Immunology
JID - 9503580
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Asthma/diagnosis/*etiology/*metabolism/therapy
MH  - Disease Management
MH  - Disease Susceptibility
MH  - Eosinophils/immunology/metabolism
MH  - Female
MH  - Humans
MH  - Japan
MH  - Male
MH  - Middle Aged
MH  - *Phenotype
MH  - Severity of Illness Index
MH  - Sputum/*immunology/*metabolism
MH  - Young Adult
EDAT- 2020/06/20 06:00
MHDA- 2021/02/02 06:00
CRDT- 2020/06/20 06:00
PHST- 2020/02/06 00:00 [received]
PHST- 2020/05/05 00:00 [revised]
PHST- 2020/06/06 00:00 [accepted]
PHST- 2020/06/20 06:00 [pubmed]
PHST- 2021/02/02 06:00 [medline]
PHST- 2020/06/20 06:00 [entrez]
AID - S1081-1206(20)30412-9 [pii]
AID - 10.1016/j.anai.2020.06.017 [doi]
PST - ppublish
SO  - Ann Allergy Asthma Immunol. 2021 Jan;126(1):54-60.e1. doi: 
      10.1016/j.anai.2020.06.017. Epub 2020 Jun 15.