Abstract

Several recent studies spanning from induced sputum to gene signature identified non-eosinophilic asthma (NEA) as a distinct asthma phenotype with several relevant clinical features such as increased asthma severity, increased remodelling and lower response to bronchodilator and anti-inflammatory treatment. Two major mechanisms leading to neutrophilic inflammation are postulated: the dysregulated innate immune response, including neutrophil intrinsic abnormalities, and the activation of the IL-17-dependent pathway. Several factors such as age, metabolic or epigenetic factors or the activation of the epithelial-mesenchimal trophic unit have been identified as modulators. The endotyping of NEA is far behind the eosinophilic asthma, and until now, no endotype-driven interventions have been proved to be effective.

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