TY - JOUR T1 - Importance of concomitant local and systemic eosinophilia in uncontrolled asthma JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - 3403 AU - Florence Schleich AU - Anne Chevremont AU - Virginie Paulus AU - Monique Henket AU - Maité Manise AU - Laurence Seidel AU - Renaud Louis Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/3403.abstract N2 - Systemic and airway eosinophilia are recognized features of asthma. There are however patients exhibiting discordance between local and systemic eosinophilia. In this study we sought to determine the prevalence and characteristics of patients with concordant and discordant systemic and bronchial eosinophilia.MethodsWe conducted a retrospective study on 508 asthmatics with successful sputum induction. We assessed the relationship between blood and sputum eosinophils by breaking down the population in 4 groups according to blood (≥400/mm³) and sputum (≥3%) eosinophils. Then we prospectively reassessed the link between eosinophils and asthma control (ACQ) and exacerbation rate in a new cohort of 250 matched asthmatics.Results In our retrospective cohort, asthmatics without eosinophilic inflammation were the largest group (49%). The group with isolated sputum eosinophilia (25%) was, compared to non eosinophilic asthma, associated with lower FEV1 and FEV1/FVC ratio and higher bronchial hyperresponsiveness (BHR) and FENO. Asthmatics exhibiting isolated systemic eosinophilia (7%) had similar characteristics as non eosinophilic. The group of concordant systemic and aiway eosinophilia (19%) showed remarkable male predominance and had the lowest airway caliber, ACQ and quality of life and the highest BHR, FENO and exacerbation rate.The prospective cohort confirmed the different subgroups proportion and the higher ACQ and exacerbation rates in case of diffuse eosinophilia compared to non eosinophilic asthmatics.ConclusionConcomitant systemic and bronchial eosinophilic inflammation contributes to poor asthma control. ER -