PMID- 35546400 OWN - NLM STAT- MEDLINE DCOM- 20220517 LR - 20220716 IS - 1465-993X (Electronic) IS - 1465-9921 (Print) IS - 1465-9921 (Linking) VI - 23 IP - 1 DP - 2022 May 11 TI - Clinical and cytokine patterns of uncontrolled asthma with and without comorbid chronic rhinosinusitis: a cross-sectional study. PG - 119 LID - 10.1186/s12931-022-02028-3 [doi] LID - 119 AB - BACKGROUND: Asthma is significantly related to chronic rhinosinusitis (CRS) both in prevalence and severity. However, the clinical patterns of uncontrolled asthma with and without comorbid CRS are still unclear. This study aimed to explore the clinical characteristics and cytokine patterns of patients with uncontrolled asthma, with and without comorbid CRS. METHODS: 22 parameters associated with demographic characteristics, CRS comorbidity, severity of airflow obstruction and airway inflammation, and inflammation type of asthma were collected and assessed in 143 patients with uncontrolled asthma. Different clusters were explored using two-step cluster analysis. Sputum samples were collected for assessment of Th1/Th2/Th17 and epithelium-derived cytokines. RESULTS: Comorbid CRS was identified as the most important variable for prediction of different clusters, followed by pulmonary function parameters and blood eosinophil level. Three clusters of patients were determined: Cluster 1 (n = 46) characterized by non-atopic patients with non-eosinophilic asthma without CRS, demonstrating moderate airflow limitation; Cluster 2 (n = 54) characterized by asthma patients with mild airflow limitation and CRS, demonstrating higher levels of blood eosinophils and immunoglobulin E (IgE) than cluster 1; Cluster 3 (n = 43) characterized by eosinophilic asthma patients with severe airflow limitation and CRS (46.5% with nasal polyps), demonstrating worst lung function, lowest partial pressure of oxygen (PaO(2)), and highest levels of eosinophils, fraction of exhaled nitric oxide (FeNO) and IgE. Sputum samples from Cluster 3 showed significantly higher levels of Interleukin (IL)-5, IL-13, IL-33, and tumor necrosis factor (TNF)-alpha than the other two clusters; and remarkably elevated IL-4, IL-17 and interferon (IFN)-gamma compared with cluster 2. The levels of IL-10 and IL-25 were not significantly different among the three clusters. CONCLUSIONS: Uncontrolled asthma may be endotyped into three clusters characterized by CRS comorbidity and inflammatory cytokine patterns. Furthermore, a united-airways approach may be especially necessary for management of asthma patients with Type 2 features. CI - (c) 2022. The Author(s). FAU - Huang, Kai AU - Huang K AD - Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730, China. FAU - Li, Fangyuan AU - Li F AD - Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730, China. FAU - Wang, Xuechen AU - Wang X AD - Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730, China. FAU - Yan, Bing AU - Yan B AD - Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100005, China. FAU - Wang, Ming AU - Wang M AD - Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100005, China. FAU - Li, Shuling AU - Li S AD - Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China. FAU - Yu, Wenling AU - Yu W AD - Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China. FAU - Liu, Xiaofang AU - Liu X AD - Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730, China. FAU - Wang, Chengshuo AU - Wang C AD - Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730, China. FAU - Jin, Jianmin AU - Jin J AD - Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730, China. jinjianmin1972@sina.com. AD - Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100005, China. jinjianmin1972@sina.com. FAU - Zhang, Luo AU - Zhang L AUID- ORCID: 0000-0002-0910-9884 AD - Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100005, China. dr.luozhang@139.com. AD - Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing, 100730, China. dr.luozhang@139.com. AD - Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China. dr.luozhang@139.com. AD - Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China. dr.luozhang@139.com. LA - eng GR - 81100704/national natural science foundation of china/ GR - 81441029/national natural science foundation of china/ GR - 81441031/national natural science foundation of china/ GR - 81570894/national natural science foundation of china/ GR - 81400444/national natural science foundation of china/ GR - 81470678/national natural science foundation of china/ GR - 2019-12M-5-022/cams innovation fund for medical sciences/ GR - IRT13082/program for changjiang scholars and innovative research team/ PT - Journal Article DEP - 20220511 PL - England TA - Respir Res JT - Respiratory research JID - 101090633 RN - 0 (Cytokines) RN - 37341-29-0 (Immunoglobulin E) SB - IM MH - *Asthma/complications/diagnosis/epidemiology MH - Chronic Disease MH - Comorbidity MH - Cross-Sectional Studies MH - Cytokines MH - Eosinophils/pathology MH - Humans MH - Immunoglobulin E MH - Inflammation/pathology MH - *Nasal Polyps/diagnosis/epidemiology MH - *Rhinitis/complications/diagnosis/epidemiology MH - *Sinusitis/complications/diagnosis/epidemiology PMC - PMC9092818 OTO - NOTNLM OT - Clinical patterns OT - Cluster analysis OT - Comorbid chronic rhinosinusitis OT - Cytokine profile OT - Uncontrolled asthma COIS- The authors declare that they have no conflicts of interest. EDAT- 2022/05/14 06:00 MHDA- 2022/05/18 06:00 PMCR- 2022/05/11 CRDT- 2022/05/13 01:44 PHST- 2021/07/12 00:00 [received] PHST- 2022/04/15 00:00 [accepted] PHST- 2022/05/13 01:44 [entrez] PHST- 2022/05/14 06:00 [pubmed] PHST- 2022/05/18 06:00 [medline] PHST- 2022/05/11 00:00 [pmc-release] AID - 10.1186/s12931-022-02028-3 [pii] AID - 2028 [pii] AID - 10.1186/s12931-022-02028-3 [doi] PST - epublish SO - Respir Res. 2022 May 11;23(1):119. doi: 10.1186/s12931-022-02028-3.