Thorax
Institute for Lung Health, Glenfield Hospital, Leicester LE3 9QP, UK.
Published: December 2007
Background: Non-eosinophilic asthma is a potentially important clinicopathological phenotype since there is evidence that it responds poorly to inhaled corticosteroid therapy. However, little is known about the underlying airway immunopathology and there are no data from placebo-controlled studies examining the effect of inhaled corticosteroids.
Methods: Airway immunopathology was investigated using induced sputum, bronchial biopsies, bronchial wash and bronchoalveolar lavage in 12 patients with symptomatic eosinophilic asthma, 11 patients with non-eosinophilic asthma and 10 healthy controls. The patients with non-eosinophilic asthma and 6 different patients with eosinophilic asthma entered a randomised, double-blind, placebo-controlled crossover study in which the effects of inhaled mometasone 400 microg once daily for 8 weeks on airway responsiveness and asthma quality of life were investigated.
Results: Patients with non-eosinophilic asthma had absence of eosinophils in the mucosa (median 4.4 cells/mm(2) vs 23 cells/mm(2) in eosinophilic asthma and 0 cells/mm(2) in normal controls; p = 0.03) and normal subepithelial layer thickness (5.8 microm vs 10.3 microm in eosinophilic asthma and 5.1 microm in controls, p = 0.002). Non-eosinophilic and eosinophilic asthma groups had increased mast cell numbers in the airway smooth muscle compared with normal controls (9 vs 8 vs 0 cells/mm(2), p = 0.016). Compared with placebo, 8 weeks of treatment with inhaled mometasone led to less improvement in methacholine PC(20) (0.5 vs 5.5 doubling concentrations, 95% CI of difference 1.1 to 9.1; p = 0.018) and asthma quality of life (0.2 vs 1.0 points, 95% CI of difference 0.27 to 1.43; p = 0.008).
Conclusions: Non-eosinophilic asthma represents a pathologically distinct disease phenotype which is characterised by the absence of airway eosinophilia, normal subepithelial layer thickness and a poor short-term response to treatment with inhaled corticosteroids.
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http://dx.doi.org/10.1136/thx.2006.073429 | DOI Listing |
Ann Allergy Asthma Immunol
January 2025
Beckman Laser Institute & Medical Clinic, University of California, Irvine, CA 92612, USA; Department of Otolaryngology - Head and Neck Surgery, University of California - Irvine, School of Medicine, Orange, CA 92868, USA; Department of Biomedical Engineering, University of California - Irvine, Irvine, CA 92697, USA. Electronic address:
Background: Chronic rhinosinusitis (CRS) is traditionally classified into CRS with or without nasal polyps and more recently into eosinophilic and non-eosinophilic endotypes. Limited research exists on the relationship between CRS subtype and mucociliary function. This study compares ciliary beat frequency (CBF) across CRS subtypes.
View Article and Find Full Text PDFArch Bronconeumol
January 2025
Department of Allergy and Clinical Immunology, Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China; Guangzhou National Laboratory, Guangzhou, Guangdong, China. Electronic address:
Objectives: To investigate the microbiota and metabolome of patients with ABO compared with bronchiectasis and asthma, and determine the relevance with clinical characteristics, inflammatory endotype and exacerbation risks.
Methods: In this prospective cohort study, patients underwent comprehensive assessments, including sputum differential cell count, and sputum collection at baseline. Sputum microbiota was profiled via 16S rRNA gene sequencing and metabolome via liquid chromatography/mass spectrometry.
J Asthma Allergy
December 2024
Respiratory Medicine, University Hospital of Liège, Liège, Belgium.
Introduction: Physical inactivity due to shortness of breath is common among patients with uncontrolled asthma. We evaluated the body mass composition and exercise capacity of patients with poorly controlled asthma, despite maximal inhalation therapy.
Methods: We recruited 56 patients from the Asthma Clinic of the University Hospital of Liège between September 2020 and December 2023, and 14 healthy subjects.
Indian Pediatr
January 2025
Community and Family Medicine, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
Objective: To estimate the proportion of eosinophilic and non-eosinophilic (NEA) endotypes in pediatric asthma, and to compare the clinical, and laboratory characterisitics, and different comorbidities between the two endotypes in the children.
Methods: Children aged 5 to 14 years of age with clinical and/or laboratory-confirmed asthma attending the pediatric outpatient department of a tertiary care hospital in Eastern India between October 1, 2023 and March 31, 2024, were included in this cross-sectional study. Complete hemogram, absolute eosinophil count (AEC), IgE, and pulmonary function tests were performed in all patients.
Clin Rev Allergy Immunol
December 2024
Division of Allergy and Clinical Immunology, The Johns Hopkins Asthma & Allergy Center, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Room 3B.71, Baltimore, MD, 21224, USA.
Asthma is a chronic airway inflammatory disease that affects millions globally. Although glucocorticoids are a mainstay of asthma treatment, a subset of patients show resistance to these therapies, resulting in poor disease control and increased morbidity. The complex mechanisms underlying steroid-resistant asthma (SRA) involve Th1 and Th17 lymphocyte activity, neutrophil recruitment, and NLRP3 inflammasome activation.
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