Universität zu Köln

Maison, Nicole ORCID: 0000-0002-8731-4218, Omony, Jimmy ORCID: 0000-0001-9983-1039, Illi, Sabina, Thiele, Dominik ORCID: 0000-0003-1073-0747, Skevaki, Chrysanthi, Dittrich, Anna -Maria, Bahmer, Thomas, Rabe, Klaus Friedrich, Weckmann, Markus ORCID: 0000-0001-5342-979X, Happle, Christine, Schaub, Bianca ORCID: 0000-0003-1652-8873, Meyer, Meike ORCID: 0000-0002-5708-3981, Foth, Svenja, Rietschel, Ernst, Renz, Harald, Hansen, Gesine, Kopp, Matthias Volkmar, von Mutius, Erika and Grychtol, Ruth (2022). T2-high asthma phenotypes across lifespan. Eur. Resp. J., 60 (3). SHEFFIELD: EUROPEAN RESPIRATORY SOC JOURNALS LTD. ISSN 1399-3003

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Abstract

Rationale In adults, personalised asthma treatment targets patients with type 2 (T2)-high and eosinophilic asthma phenotypes. It is unclear whether such classification is achievable in children. Objectives To define T2-high asthma with easily accessible biomarkers and compare resulting phenotypes across all ages. Methods In the multicentre clinical All Age Asthma Cohort (ALLIANCE), 1125 participants (n=776 asthmatics, n=349 controls) were recruited and followed for 2 years (1 year in adults). Extensive clinical characterisation (questionnaires, blood differential count, allergy testing, lung function and sputum induction (in adults)) was performed at baseline and follow-ups. Interleukin (IL)-4, IL-5 and IL-13 were measured after stimulation of whole blood with lipopolysaccharide (LPS) or anti-CD3/CD28.Measurements and main results Based on blood eosinophil counts and allergen-specific serum IgE antibodies, patients were categorised into four mutually exclusive phenotypes: atopy-only, eosinophils-only, T2-high (eosinophilia + atopy) and T2-low (neither eosinophilia nor atopy). The T2-high phenotype was found across all ages, even in very young children in whom it persisted to a large degree even after 2 years of follow-up. T2-high asthma in adults was associated with childhood onset, suggesting early origins of this asthma phenotype. In both children and adults, the T2-high phenotype was characterised by excessive production of specific IgE to allergens (p<0.0001) and, from school age onwards, by increased production of IL-5 after anti-CD3/CD28 stimulation of whole blood. Conclusions Using easily accessible biomarkers, patients with T2-high asthma can be identified across all ages delineating a distinct phenotype. These patients may benefit from therapy with biologicals even at a younger age.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Maison, Nicole UNSPECIFIED orcid.org/0000-0002-8731-4218 UNSPECIFIED Omony, Jimmy UNSPECIFIED orcid.org/0000-0001-9983-1039 UNSPECIFIED Illi, Sabina UNSPECIFIED UNSPECIFIED UNSPECIFIED Thiele, Dominik UNSPECIFIED orcid.org/0000-0003-1073-0747 UNSPECIFIED Skevaki, Chrysanthi UNSPECIFIED UNSPECIFIED UNSPECIFIED Dittrich, Anna -Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Bahmer, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Rabe, Klaus Friedrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Weckmann, Markus UNSPECIFIED orcid.org/0000-0001-5342-979X UNSPECIFIED Happle, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaub, Bianca UNSPECIFIED orcid.org/0000-0003-1652-8873 UNSPECIFIED Meyer, Meike UNSPECIFIED orcid.org/0000-0002-5708-3981 UNSPECIFIED Foth, Svenja UNSPECIFIED UNSPECIFIED UNSPECIFIED Rietschel, Ernst UNSPECIFIED UNSPECIFIED UNSPECIFIED Renz, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Hansen, Gesine UNSPECIFIED UNSPECIFIED UNSPECIFIED Kopp, Matthias Volkmar UNSPECIFIED UNSPECIFIED UNSPECIFIED von Mutius, Erika UNSPECIFIED UNSPECIFIED UNSPECIFIED Grychtol, Ruth UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-693600
DOI:	10.1183/13993003.02288-2021
Journal or Publication Title:	Eur. Resp. J.
Volume:	60
Number:	3
Date:	2022
Publisher:	EUROPEAN RESPIRATORY SOC JOURNALS LTD
Place of Publication:	SHEFFIELD
ISSN:	1399-3003
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BLOOD EOSINOPHIL COUNTS; TYPE-2 INFLAMMATION; SUBPHENOTYPES Multiple languages Respiratory System Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69360