Abstract
Introduction: In asthma, several types of airway inflammation have been described (Simpson Respirology 2006), which may represent clinically different subtypes of asthma. Whether non-atopic asthma can also be divided into different subtypes according to airway inflammation is unknown.
Aim: To investigate whether different inflammatory profiles correspond with distinct clinical and functional characteristics in patients with non-atopic asthma.
Methods: In a cross-sectional study we included outpatients with non-atopic asthma and divided them into 4 types of airway inflammation. All patients filled out questionnaires (co-morbidity, ACQ, AQLQ, Sino-Nasal outcome Test (SNOT)) and underwent spirometry, blood tests, sputum induction and nasal endoscopy.
Results: 62 patients (90% adult onset) were included. We found no differences in BMI, questionnaires or spirometry. Differences between groups: see Table 1.
Conclusion: Almost all adult non-atopic asthma patients have their onset of asthma in adulthood. There are at least 2 distinct phenotypes: an eosinophilic phenotype, characterized by male gender, high levels of IgE and nasal polyps, and a neutrophilic phenotype associated with extra-pulmonary auto-immune diseases.
Implication: Fenotype specific therapies, that might improve outcome of non-atopic asthma, should be further evaluated.
- © 2011 ERS