2型炎症亚型在未选择重症哮喘患者人群中的患病率
2020/11/17
摘要
背景：随着针对T2型哮喘不同靶向治疗方法的引入，迫切需要标记物来指导治疗方案的选择。高T2型哮喘包括不同临床表型的哮喘，但不同T2炎症通路激活的患病率和影响尚不清楚。
目的：探讨临床上可用的T2炎症标志物在重症哮喘患者中的共表达水平及其与临床特征和共患病的关系。
方法：对符合ERS/ATS指南的重症哮喘患者进行前瞻性检查，包括诱导痰，并根据T2生物标志物进行分组：血嗜酸性粒细胞（≥0.3∙109/L）、总IgE（≥150u/mL）和FeNO（≥25ppb）。
结果：我们发现166例患者中有116例（70%）至少有一种T2生物标志物升高：39%的患者有两种或两种以上的生物标志物升高，31%的患者只有一种生物标志物升高。28%的患者伴有气道和全身嗜酸性粒细胞增多症，相当于其中一半（53%）的患者。T2生物标志物的表达模式与过敏反应的差异和鼻息肉病的共存有关。
结论：绝大多数重症哮喘患者至少表现出一种T2炎症特征。T2生物标志物的共表达具有高度的异质性，不同的表达模式与不同的临床特征相关。
The prevalence of subtypes of type-2 inflammation in an unselected population of patients with severe asthma
Laurits Frøssing, Alexander Silberbrandt, Anna Von Bülow, Vibeke Backer, Celeste Porsbjerg
Abstract
Background: With the introduction of different targeted therapies for T2 high asthma, there is an urgent need for markers to guide the choice of treatment. T2 high asthma includes different clinical phenotypes of asthma, but the prevalence and impact of activation of different T2 inflammatory pathways is unknown.
Objective: We aimed to describe the level of co-expression of clinically available T2 inflammatory markers in patients with severe asthma, and the relationship with clinical characteristics and co-morbidities.
Methods: Patients with severe asthma according to ERS/ATS guidelines were examined prospectively including sputum induction and grouped according to T2 biomarkers: blood eosinophilia (≥0.3 ∙ 109/L), total IgE (≥150 U/mL) and FeNO (≥25ppb).
Results: We found 116 (70%) of the 166 patients to have at least one T2 biomarker elevated: 39% had two or more elevated biomarkers while 31% had only one biomarker elevated. Concomitant airway- and systemic eosinophilia was present in 28% of all patients corresponding to half (53%) of the patients with either . Expression patterns of the T2 biomarkers were associated with differences in allergic sensitisation and the co-existence of nasal polyposis.
Conclusion: The majority of patients with severe asthma showed at least one T2 inflammatory trait. Co-expression of T2 biomarkers was highly heterogeneous, and different expression patterns were associated with distinct clinical characteristics.
背景：随着针对T2型哮喘不同靶向治疗方法的引入，迫切需要标记物来指导治疗方案的选择。高T2型哮喘包括不同临床表型的哮喘，但不同T2炎症通路激活的患病率和影响尚不清楚。
目的：探讨临床上可用的T2炎症标志物在重症哮喘患者中的共表达水平及其与临床特征和共患病的关系。
方法：对符合ERS/ATS指南的重症哮喘患者进行前瞻性检查，包括诱导痰，并根据T2生物标志物进行分组：血嗜酸性粒细胞（≥0.3∙109/L）、总IgE（≥150u/mL）和FeNO（≥25ppb）。
结果：我们发现166例患者中有116例（70%）至少有一种T2生物标志物升高：39%的患者有两种或两种以上的生物标志物升高，31%的患者只有一种生物标志物升高。28%的患者伴有气道和全身嗜酸性粒细胞增多症，相当于其中一半（53%）的患者。T2生物标志物的表达模式与过敏反应的差异和鼻息肉病的共存有关。
结论：绝大多数重症哮喘患者至少表现出一种T2炎症特征。T2生物标志物的共表达具有高度的异质性，不同的表达模式与不同的临床特征相关。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2020 Oct 8;S2213-2198(20)31101-6. doi: 10.1016/j.jaip.2020.09.051. Online ahead of print.)
(J Allergy Clin Immunol Pract. 2020 Oct 8;S2213-2198(20)31101-6. doi: 10.1016/j.jaip.2020.09.051. Online ahead of print.)
The prevalence of subtypes of type-2 inflammation in an unselected population of patients with severe asthma
Laurits Frøssing, Alexander Silberbrandt, Anna Von Bülow, Vibeke Backer, Celeste Porsbjerg
Abstract
Background: With the introduction of different targeted therapies for T2 high asthma, there is an urgent need for markers to guide the choice of treatment. T2 high asthma includes different clinical phenotypes of asthma, but the prevalence and impact of activation of different T2 inflammatory pathways is unknown.
Objective: We aimed to describe the level of co-expression of clinically available T2 inflammatory markers in patients with severe asthma, and the relationship with clinical characteristics and co-morbidities.
Methods: Patients with severe asthma according to ERS/ATS guidelines were examined prospectively including sputum induction and grouped according to T2 biomarkers: blood eosinophilia (≥0.3 ∙ 109/L), total IgE (≥150 U/mL) and FeNO (≥25ppb).
Results: We found 116 (70%) of the 166 patients to have at least one T2 biomarker elevated: 39% had two or more elevated biomarkers while 31% had only one biomarker elevated. Concomitant airway- and systemic eosinophilia was present in 28% of all patients corresponding to half (53%) of the patients with either . Expression patterns of the T2 biomarkers were associated with differences in allergic sensitisation and the co-existence of nasal polyposis.
Conclusion: The majority of patients with severe asthma showed at least one T2 inflammatory trait. Co-expression of T2 biomarkers was highly heterogeneous, and different expression patterns were associated with distinct clinical characteristics.
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