TY - JOUR T1 - Severe asthma exists despite suppressed tissue inflammation: findings of the U-BIOPRED study JF - European Respiratory Journal JO - Eur Respir J SP - 1307 LP - 1319 DO - 10.1183/13993003.01129-2016 VL - 48 IS - 5 AU - Susan J. Wilson AU - Jonathan A. Ward AU - Ana R. Sousa AU - Julie Corfield AU - Aruna T. Bansal AU - Bertrand De Meulder AU - Diane Lefaudeux AU - Charles Auffray AU - Matthew J. Loza AU - Frederic Baribaud AU - Neil Fitch AU - Peter J. Sterk AU - Kian Fan Chung AU - David Gibeon AU - Kai Sun AU - Yi-ke Guo AU - Ian Adcock AU - Ratko Djukanovic AU - Barbro Dahlen AU - Pascal Chanez AU - Dominick Shaw AU - Norbert Krug AU - Jens Hohlfeld AU - Thomas Sandström AU - Peter H. Howarth Y1 - 2016/11/01 UR - http://erj.ersjournals.com/content/48/5/1307.abstract N2 - The U-BIOPRED study is a multicentre European study aimed at a better understanding of severe asthma. It included three steroid-treated adult asthma groups (severe nonsmokers (SAn group), severe current/ex-smokers (SAs/ex group) and those with mild–moderate disease (MMA group)) and healthy controls (HC group). The aim of this cross-sectional, bronchoscopy substudy was to compare bronchial immunopathology between these groups.In 158 participants, bronchial biopsies and bronchial epithelial brushings were collected for immunopathologic and transcriptomic analysis. Immunohistochemical analysis of glycol methacrylate resin-embedded biopsies showed there were more mast cells in submucosa of the HC group (33.6 mm−2) compared with both severe asthma groups (SAn: 17.4 mm−2, p<0.001; SAs/ex: 22.2 mm−2, p=0.01) and with the MMA group (21.2 mm−2, p=0.01). The number of CD4+ lymphocytes was decreased in the SAs/ex group (4.7 mm−2) compared with the SAn (11.6 mm−2, p=0.002), MMA (10.1 mm−2, p=0.008) and HC (10.6 mm−2, p<0.001) groups. No other differences were observed.Affymetrix microarray analysis identified seven probe sets in the bronchial brushing samples that had a positive relationship with submucosal eosinophils. These mapped to COX-2 (cyclo-oxygenase-2), ADAM-7 (disintegrin and metalloproteinase domain-containing protein 7), SLCO1A2 (solute carrier organic anion transporter family member 1A2), TMEFF2 (transmembrane protein with epidermal growth factor like and two follistatin like domains 2) and TRPM-1 (transient receptor potential cation channel subfamily M member 1); the remaining two are unnamed.We conclude that in nonsmoking and smoking patients on currently recommended therapy, severe asthma exists despite suppressed tissue inflammation within the proximal airway wall.Severe asthma exists despite suppressed tissue inflammation in proximal airways when on current recommended therapy http://ow.ly/1rb6303haKP ER -