PT  - JOURNAL ARTICLE
AU  - Stelios Pavlidis
AU  - Kentaro Takahashi
AU  - Francois Ng Kee Kwong
AU  - Jiaxing Xie
AU  - Uruj Hoda
AU  - Kai Sun
AU  - Vahid Elyasigomari
AU  - Paul Agapow
AU  - Matthew Loza
AU  - Fred Baribaud
AU  - Pascal Chanez
AU  - Steve J. Fowler
AU  - Dominic E. Shaw
AU  - Louise J. Fleming
AU  - Peter H. Howarth
AU  - Ana R. Sousa
AU  - Julie Corfield
AU  - Charles Auffray
AU  - Bertrand De Meulder
AU  - Richard Knowles
AU  - Peter J. Sterk
AU  - Yike Guo
AU  - Ian M. Adcock
AU  - Ratko Djukanovic
AU  - Kian Fan Chung
ED  - ,
TI  - “T2-high” in severe asthma related to blood eosinophil, exhaled nitric oxide and serum periostin
AID  - 10.1183/13993003.00938-2018
DP  - 2019 Jan 01
TA  - European Respiratory Journal
PG  - 1800938
VI  - 53
IP  - 1
4099  - http://erj.ersjournals.com/content/53/1/1800938.short
4100  - http://erj.ersjournals.com/content/53/1/1800938.full
SO  - Eur Respir J2019 Jan 01; 53
AB  - Type-2 (T2) immune responses in airway epithelial cells (AECs) classifies mild–moderate asthma into a T2-high phenotype. We examined whether currently available clinical biomarkers can predict AEC-defined T2-high phenotype within the U-BIOPRED cohort.The transcriptomic profile of AECs obtained from brushings of 103 patients with asthma and 44 healthy controls was obtained and gene set variation analysis used to determine the relative expression score of T2 asthma using a signature from interleukin (IL)-13-exposed AECs.37% of asthmatics (45% nonsmoking severe asthma, n=49; 33% of smoking or ex-smoking severe asthma, n=18; and 28% mild–moderate asthma, n=36) were T2-high using AEC gene expression. They were more symptomatic with higher exhaled nitric oxide fraction (FeNO) and blood and sputum eosinophils, but not serum IgE or periostin. Sputum eosinophilia correlated best with the T2-high signature. FeNO (≥30 ppb) and blood eosinophils (≥300 cells·µL−1) gave a moderate prediction of T2-high asthma. Sputum IL-4, IL-5 and IL-13 protein levels did not correlate with gene expression.T2-high severe asthma can be predicted to some extent from raised levels of FeNO, blood and sputum eosinophil counts, but serum IgE or serum periostin were poor predictors. Better bedside biomarkers are needed to detect T2-high.T2-high was found in 45% of nonsmoking and 33% of smoking/ex-smoking severe asthma and 28% of mild–moderate asthma. This can be predicted from raised levels of nitric oxide in exhaled breath, blood and sputum eosinophil counts, but not from serum periostin. http://ow.ly/Zsq630myR9t