Blood granulocyte patterns as predictors of asthma phenotypes in adults from the EGEA study
Blood granulocyte patterns as predictors of asthma phenotypes in adults from the EGEA study
复制标题
DOI：
10.1183/13993003.00336-2016
复制
发表时间：
2016-10-01
影响因子：
24.3
通讯作者：
Pin, Isabelle
中科院分区：
文献类型：
--
作者：
Nadif, Rachel;Siroux, Valerie;Pin, Isabelle
在何种程度上，血液粒细胞模式可以预测哮喘控制仍有待研究。我们的目的是研究血嗜酸性粒细胞和嗜酸性粒细胞与成人哮喘控制结果之间的关系，分析了474例哮喘患者的遗传学和环境的流行病学研究（EGEA 2）的第一次随访，其中包括242例10年前的成人哮喘患者（EGEA 1）。在EGEA 2中，使用全球哮喘倡议定义（2015）评估哮喘控制，并通过过去一年使用紧急护理或口服皮质类固醇疗程评估哮喘急性发作。血液EOSlo/EOShi分别定义为≥ 250嗜酸性粒细胞.mm（-3），NEUlo/NEUhi分别定义为≥ 5000中性粒细胞.mm（-3）。在EGEA 2中，NEUhi与哮喘急性发作和哮喘控制不良相关（OR > 2.10）。EOShi与较高的支气管高反应性（BHR）（OR（95% CI）2.21（1.24-3.97））、较差的肺功能（p= 0.02）和较高的总IgE水平（p= 0.002）相关。几乎50%的哮喘患者在两次调查之间有持续的模式。持续性NEUhi与EGEA 2时哮喘控制不良相关（OR（95% CI）3.09（1.18-7.05））。EGEA 1时的EOShi和持续性EOShi与较高的BHR相关（OR（95% CI）2.36（1.10-5.07）和3.85（1.11-13.34）），肺功能差（p< 0.06）和较高的免疫球蛋白E水平（p< 10（-4））。粒细胞类型与哮喘结果有不同的相关性，提示每种类型都有特定的作用，可以作为预测标志进行测试。
To what extent blood granulocyte patterns may predict asthma control remains understudied. Our aim was to study associations between blood neutrophilia and eosinophilia and asthma control outcomes in adults.Analyses were conducted in 474 asthmatics from the first follow-up of the Epidemiological Study on the Genetics and Environment of Asthma (EGEA2), including 242 asthmatics who were adults a decade earlier (EGEA1). At EGEA2, asthma control was assessed using the Global Initiative for Asthma definition (2015), and asthma exacerbations by use of urgent care or courses of oral corticosteroids in the past year. Blood EOSlo/EOShi was defined as = 250 eosinophils.mm(-3), respectively, and NEUlo/NEUhi as = 5000 neutrophils.mm(-3), respectively. Estimates were adjusted for age, sex and smoking.At EGEA2, NEUhi was associated with asthma exacerbations and poor asthma control (OR > 2.10). EOShi was associated with higher bronchial hyperresponsiveness (BHR) (OR (95% CI) 2.21 (1.24-3.97)), poor lung function (p= 0.02) and higher total IgE level (p= 0.002). Almost 50% of asthmatics had a persistent pattern between surveys. Persistent NEUhi was associated with poor asthma control at EGEA2 (OR (95% CI) 3.09 (1.18-7.05)). EOShi at EGEA1 and persistent EOShi were associated with higher BHR (OR (95% CI) 2.36 (1.10-5.07) and 3.85 (1.11-13.34), respectively), poor lung function (p< 0.06) and higher immunoglobulin E level (p< 10(-4)) at EGEA2.Granulocyte patterns were differently associated with asthma outcomes, suggesting specific roles for each one, which could be tested as predictive signatures.