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Associated factors with persistent airflow limitation in asthma in U-BIOPRED

A. Wagener, D. Gibeon, X. Yang, A. Sousa, J. Corfield, D. Shaw, S. Fowler, L. Fleming, J. Riley, L. Jeyasingham, A. Rowe, K. Fichtner, G. Roberts, P. Bakke, F. Singer, T. Geiser, U. Frey, I. Horvarth, R. Polosa, K. Bønnelykke, N. Krug, R. Middelveld, S.-E. Dahlen, B. Dahlen, G. Hedlin, S. Hashimoto, B. Nordlund, J. Musial, A. Woodcock, C. Murray, L. Pahus, P. Chanez, D. Myles, C. Compton, T.W. Higenbottam, P. Montuschi, J. Vestbo, L. Larsson, T. Sandstrom, H. Bisgaard, S.S. Wagers, P.H. Howarth, E.H. Bel, R. Djukanovic, F. Chung, P. Sterk
European Respiratory Journal 2013 42: P3142; DOI:
A. Wagener
2Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
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D. Gibeon
1NHLI, Imperial College London, London, United Kingdom
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X. Yang
1NHLI, Imperial College London, London, United Kingdom
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A. Sousa
3Respiratory Therapy Unit, GlaxoSmithKline, London, United Kingdom
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J. Corfield
4Clinical Research, AstraZeneca, Lund, Sweden
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D. Shaw
5Nottingham Respiratory Research Unit, Nottingham City Hospital, Nottingham, United Kingdom
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S. Fowler
6Respiratory Medicine, University of Manchester and Lancashire Teaching Hospitals NHS Foundation Trust, Manchester, United Kingdom
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L. Fleming
1NHLI, Imperial College London, London, United Kingdom
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J. Riley
3Respiratory Therapy Unit, GlaxoSmithKline, London, United Kingdom
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L. Jeyasingham
3Respiratory Therapy Unit, GlaxoSmithKline, London, United Kingdom
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A. Rowe
7External Innovation, R&D IT, Janssen Research and Development, London, United Kingdom
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K. Fichtner
8Global Clinical Operations, Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, United Kingdom
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G. Roberts
9Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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P. Bakke
10Respiratory Medicine, Haukeland University Hospital, Bergen, Norway
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F. Singer
11Respiratory Medicine, Inselspital and University of Bern, Bern, Switzerland
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T. Geiser
11Respiratory Medicine, Inselspital and University of Bern, Bern, Switzerland
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U. Frey
11Respiratory Medicine, Inselspital and University of Bern, Bern, Switzerland
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I. Horvarth
12Department of Pulmonology, Semmelweis University, Budapest, United Kingdom
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R. Polosa
13Medicine and Immunology Clinic, University of Catania, Catania, Italy
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K. Bønnelykke
14University Hospital, University Hospital, Copenhagen, Copenhagen, Denmark
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N. Krug
15Medicine, Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
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R. Middelveld
16The Centre for Allergy Research, Karolinska Insitute, Stockholm, Sweden
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S.-E. Dahlen
16The Centre for Allergy Research, Karolinska Insitute, Stockholm, Sweden
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B. Dahlen
16The Centre for Allergy Research, Karolinska Insitute, Stockholm, Sweden
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G. Hedlin
16The Centre for Allergy Research, Karolinska Insitute, Stockholm, Sweden
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S. Hashimoto
2Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
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B. Nordlund
16The Centre for Allergy Research, Karolinska Insitute, Stockholm, Sweden
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J. Musial
17Medical College, Jagiellonian University, Krakow, Poland
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A. Woodcock
6Respiratory Medicine, University of Manchester and Lancashire Teaching Hospitals NHS Foundation Trust, Manchester, United Kingdom
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C. Murray
6Respiratory Medicine, University of Manchester and Lancashire Teaching Hospitals NHS Foundation Trust, Manchester, United Kingdom
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L. Pahus
18Hopital Nord, Bureau De Recherche Clinique, Université De La Méditerranee, Marseille, France
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P. Chanez
18Hopital Nord, Bureau De Recherche Clinique, Université De La Méditerranee, Marseille, France
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D. Myles
3Respiratory Therapy Unit, GlaxoSmithKline, London, United Kingdom
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C. Compton
19Horsham Research Center, Novartis Pharma AG, Horsham, United Kingdom
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T.W. Higenbottam
20Chiesi Research, Chiesi, London, United Kingdom
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P. Montuschi
21Istituto Di Farmacologia, Università Cattolica Del Sacro Cuore, Rome, Italy
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J. Vestbo
22Lungemedicinsk Sektion, Hvidovre Hospital, Hvidovre, Denmark
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L. Larsson
4Clinical Research, AstraZeneca, Lund, Sweden
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T. Sandstrom
23Respiratory and Allergy Division, University Hospital, Umeå, Umeå, Sweden
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H. Bisgaard
14University Hospital, University Hospital, Copenhagen, Copenhagen, Denmark
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S.S. Wagers
24BioSci Consulting, BioSci Consulting, Maasmechelen, Belgium
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P.H. Howarth
9Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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E.H. Bel
2Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
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R. Djukanovic
9Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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F. Chung
1NHLI, Imperial College London, London, United Kingdom
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P. Sterk
2Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
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Abstract

Rationale

Current therapeutic options fail to prevent or reverse irreversible obstruction in some patients with asthma. Careful phenotyping will allow more detailed understanding of the underlying pathophysiology, such as the accompanying inflammatory pathways. This can promote the development of targeted prophylaxis or treatment.

Aim

To examine whether fixed airways obstruction in patients with asthma is associated with markers of airway inflammation, FeNO, total IgE, and BMI.

Methods

This was a cross-sectional analysis of the U-BIOPRED cohort. Severe asthma was defined by the IMI-criteria (Bel et al. Thorax 2011). Patients with mild/moderate asthma used ICS (≤500mcg FP), were (partly) controlled according to GINA-criteria, and were (ex)non-smokers (≤5 py). Fixed airways obstruction was defined as a postbronchodilator FEV1 or FEV1/FVC < 75% predicted with a TLC>75% predicted. Wilcoxon rank sum test was used to test for associating factors.

Results

Data were available for 148 patients, of which 118 with severe asthma. Persistent airflow limitation was observed in 46% of the patients and was significantly associated with sputum eosinophils (Sp.eos.), sputum alveolar macrophages (Sp.alv.macroph.) and age (Table 1).

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Table 1

Conclusion

This preliminary analysis of the U-BIOPRED cohort shows that fixed airflow limitation in asthma is associated with elevated sputum eosinophils and lower sputum alveolar macrophages, suggesting a distinguishable inflammatory profile in the airways.

  • Asthma - diagnosis
  • Biomarkers
  • Inflammation
  • © 2013 ERS
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Associated factors with persistent airflow limitation in asthma in U-BIOPRED
A. Wagener, D. Gibeon, X. Yang, A. Sousa, J. Corfield, D. Shaw, S. Fowler, L. Fleming, J. Riley, L. Jeyasingham, A. Rowe, K. Fichtner, G. Roberts, P. Bakke, F. Singer, T. Geiser, U. Frey, I. Horvarth, R. Polosa, K. Bønnelykke, N. Krug, R. Middelveld, S.-E. Dahlen, B. Dahlen, G. Hedlin, S. Hashimoto, B. Nordlund, J. Musial, A. Woodcock, C. Murray, L. Pahus, P. Chanez, D. Myles, C. Compton, T.W. Higenbottam, P. Montuschi, J. Vestbo, L. Larsson, T. Sandstrom, H. Bisgaard, S.S. Wagers, P.H. Howarth, E.H. Bel, R. Djukanovic, F. Chung, P. Sterk
European Respiratory Journal Sep 2013, 42 (Suppl 57) P3142;

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Associated factors with persistent airflow limitation in asthma in U-BIOPRED
A. Wagener, D. Gibeon, X. Yang, A. Sousa, J. Corfield, D. Shaw, S. Fowler, L. Fleming, J. Riley, L. Jeyasingham, A. Rowe, K. Fichtner, G. Roberts, P. Bakke, F. Singer, T. Geiser, U. Frey, I. Horvarth, R. Polosa, K. Bønnelykke, N. Krug, R. Middelveld, S.-E. Dahlen, B. Dahlen, G. Hedlin, S. Hashimoto, B. Nordlund, J. Musial, A. Woodcock, C. Murray, L. Pahus, P. Chanez, D. Myles, C. Compton, T.W. Higenbottam, P. Montuschi, J. Vestbo, L. Larsson, T. Sandstrom, H. Bisgaard, S.S. Wagers, P.H. Howarth, E.H. Bel, R. Djukanovic, F. Chung, P. Sterk
European Respiratory Journal Sep 2013, 42 (Suppl 57) P3142;
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