PT - JOURNAL ARTICLE AU - Hajar Ali AU - Collin Brooks AU - Julian Crane AU - Richard Beasley AU - Graham Le Gros AU - Stephen Holgate AU - Peter Gibson AU - Philip Pattemore AU - Thorsten Stanley AU - Shieak Yc Tzeng AU - Neil Pearce AU - Jeroen Douwes TI - Airway sensory nerve sensitivity in adolescents with eosinophilic and non-eosinophilic asthma AID - 10.1183/13993003.congress-2020.4081 DP - 2020 Sep 07 TA - European Respiratory Journal PG - 4081 VI - 56 IP - suppl 64 4099 - http://erj.ersjournals.com/content/56/suppl_64/4081.short 4100 - http://erj.ersjournals.com/content/56/suppl_64/4081.full SO - Eur Respir J2020 Sep 07; 56 AB - Background: Neural pathways may play a role in non-eosinophilic asthma, but this has rarely been studied.Aims: To assess whether non-eosinophilic asthma is characterised by increased sensory nerve sensitivity compared to eosinophilic asthmatics and controls.Methods: We recruited 38 asthmatics (18 eosinophilic and 20 non-eosinophilic) and 19 non-asthmatics (14-21 years) who underwent a capsaicin challenge, combined sputum induction and airway hyperreactivity (AHR), exhaled nitric oxide (FENO), atopy and spirometry tests. Sensory nerve sensitivity was defined as the lowest capsaicin concentration that evoked 2 (C2) or 5 (C5) coughs.Results: Non-eosinophilic asthmatics (NEA; eosinophil cut-point <2.5%) had a significantly lower C5 (heightened sensitivity) compared to controls (C5: Geometric Mean (GM) 58.3, 95% CL 24.1-141.5 vs 193.6, 82.2-456.0; p<0.05). C5 was also lower in NEA when compared to eosinophilic asthmatics (EA), but this did not reach statistical significance (58.3, 24.1-141.5 vs 191.0, 70.9-514.0; p=0.07). C5 was associated with ethnicity and sensitivity analyses excluding non-Europeans (n=8) (thus reducing confounding) resulted in a more pronounced difference between EA and NEA (p<0.05). No differences in C2 were found (control, 28.0, 12.3-63.6; EA, 41.5, 13.6-126.6; NEA, 17.9, 9.0-37.1). FEV1 was significantly reduced from baseline after capsaicin inhalation in both asthmatics and non-asthmatics but no differences were found across the groups. No other associations with demographic characteristics or other clinical outcomes were observed.Conclusion: Heightened airway sensory sensitivity may play a role in non-eosinophilic asthma.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4081.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).