Abstract
BackgroundThe inflammatory phenotypes of asthma predict the treatment response and prognosis. The phenotype distributions differ depending on the geographical region. This study aimed to assess the distribution of different inflammatory phenotypes among asthma patients in Jilin Province, China.MethodsA total of 255 patients with asthma were recruited from Jilin Province, China for this cross-sectional study. Each patient underwent sputum induction following clinical assessment and peripheral blood collection. Inflammatory phenotypes were classified according to the inflammatory cell counts in the sputum.ResultsPaucigranulocytic asthma (PGA) was the most common inflammatory phenotype (52.2%), followed by eosinophilic asthma (EA, 38.3%), mixed granulocytic asthma (MGA, 5.2%), and neutrophilic asthma (NA, 4.3%). NA was more common among patients over 45 years old and those who were treated with higher doses of inhaled corticosteroids (ICS), but was less common following antibiotics treatment (p < 0.05). The proportion of patients with EA decreased as the ICS treatment dose and time increased (p = 0.038). Patients with uncontrolled asthma had higher numbers of sputum eosinophils and neutrophils (p < 0.05). Patients with severe asthma had a higher percentage of sputum neutrophils (p < 0.05). A greater proportion of patients with NA had severe asthma (60%) compared to those with EA (18.2%) (p = 0.016).ConclusionsThe most common asthma inflammatory cell phenotype in Jilin Province, China is PGA, followed by EA, MGA, and NA. The low prevalence of NA in Jilin Province compared to other countries and also other regions in China might be due to excessive antibiotic use and irregular ICS treatment in this region.
Highlights
The inflammatory phenotypes of asthma predict the treatment response and prognosis
Demographic, functional, and inflammatory characteristics of patients with asthma vs healthy person In total, 255 patients with asthma and 22 healthy volunteers were enrolled in this study (Table 1)
The success rates of sputum induction in both asthmatic patients and healthy volunteers were higher than 80%
Summary
The inflammatory phenotypes of asthma predict the treatment response and prognosis. The phenotype distributions differ depending on the geographical region. Asthmatic airway inflammation is characterized by the infiltration of different types of inflammatory cells (neutrophils, eosinophils, T lymphocytes, etc.) in the airway tissue and the secretion of a variety of inflammatory mediators and cytokines. Half of the patients with mild-to-moderate or refractory asthma experience persistent non-eosinophilic inflammation [9, 10]. Unlike EA patients, patients with NA respond poorly to glucocorticoid treatment even when their condition is only mild to moderate [9], and more develop severe asthma or refractory asthma, which is characterized by persistent airway limitation [11]. It is important that patients with asthma receive individualized treatment according to their specific inflammatory phenotype
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