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Heterogeneity of asthma according to blood inflammatory patterns.

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  • Additional Information
    • Contributors:
      Recherche en épidémiologie et biostatistique; Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM); Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823); Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM); Département d'information médicale / Hôpital Plaisir-Grignon (DIM); Hôpital gérontologique et médico-social de Plaisir-Grignon; Service de Pédiatrie; Centre Hospitalier Universitaire CHU Grenoble (CHUGA); GA2LEN project, Global Allergy and Asthma European Network.; EGEA; ANR-05-SEST-0020,ANR-05-SEST-0020,Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie(2005)
    • Publication Information:
      HAL CCSD
      BMJ Publishing Group
    • Publication Date:
      2009
    • Collection:
      Université Grenoble Alpes: HAL
    • Abstract:
      Word count: 3032. ; International audience ; RATIONALE: There is increasing interest regarding asthma heterogeneity in relation to inflammatory patterns. OBJECTIVES: To assess phenotypic characteristics, in particular clinical presentation of the disease, in 381 well-characterised adults with asthma from the French Epidemiological study on the Genetics and Environment of Asthma (EGEA) according to their blood inflammatory pattern. METHODS: Four blood inflammatory patterns were defined according to eosinophil (EOS) and neutrophil (NEU) count cut-off points. Samples with > or =250 EOS/mm(3) were classified as EOS(hi) and those with > or =5000 NEU/mm(3) as NEU(hi). Clinical characteristics include typical asthma and chronic obstructive pulmonary disease (COPD)-like symptoms, as well as composite quantitative scores addressing the activity of the disease. RESULTS: A substantial number of those with asthma (56.2%) had the EOS(lo) pattern (<250 EOS/mm(3)). Patients with asthma who had the EOS(hi) pattern had higher immunoglobulin E (IgE), a lower forced expiratory volume in 1 s (FEV(1)) and presented a more active asthma than those with the EOS(lo) pattern. Among those with the EOS(lo) pattern, neutrophil inflammation (NEU(hi)) was related to a less frequent positive skin prick test response (OR 0.44, 95% CI 0.20 to 0.96). Among those with the EOS(hi) pattern, neutrophil inflammation did not explain current asthma or asthma activity, and was significantly related to nocturnal symptoms (OR 5.21, 95% CI 1.44 to 18.8) independently of age, sex, smoking and inhaled corticosteroid treatment. In non-smokers with asthma, COPD-like symptoms, in particular chronic phlegm, were more frequent in those with neutrophil inflammation, independent of eosinophil inflammation (OR 2.35, 95% CI 1.08 to 5.10). CONCLUSIONS: Besides eosinophilia, neutrophil inflammation assessed in the blood is related to specific characteristics of asthma. Considering simultaneously neutrophilic and eosinophilic inflammation may contribute to help ...
    • Relation:
      info:eu-repo/semantics/altIdentifier/pmid/19131450; PUBMED: 19131450
    • Accession Number:
      10.1136/thx.2008.103069
    • Online Access:
      https://inserm.hal.science/inserm-00349133
      https://inserm.hal.science/inserm-00349133v1/document
      https://inserm.hal.science/inserm-00349133v1/file/nadif_t_2008_sp.pdf
      https://doi.org/10.1136/thx.2008.103069
    • Rights:
      info:eu-repo/semantics/OpenAccess
    • Accession Number:
      edsbas.69A64CA9