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Clinical subtypes of neutrophilic asthma: a cluster analysis from Australasian Severe Asthma Network

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作者：
He Li Xiu[1,2,3,4] * ; Deng Ke[1,2,4] * ; Wang Ji[1,2,4] * ; Zhang Xin[4,5] ; Wang Lei[4,5] ; Zhang Hong Ping[4,5] ; Xie Min[6] ; Chen Zhi Hong[7] ; Zhang Jie[8] ; Hsu Alan Chen-Yu[9] ; Zhang Li[1,2,4,5] ; Oliver Brian G[10,11] ; Wark Peter A B[12,13] ; Qin Ling[14] ; Gao Peng[8] ; Wan Hua Jing[1,4] ; Liu Dan[1,2,15] ; Luo Feng Ming[1,2,4] ; Li Wei Min[1,2,15,*2] ; Wang Gang[1,2,4,*1] ; Gibson Peter Gerard[12,13,16] ;
单位： [1]Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610041, China. [2]State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu 610041, China. [3]Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou, China. [4]Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, Sichuan University, Chengdu 610041, China. [5]Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China. [6]Department of Respiratory and Critical Care Medicine, Tongji Hospital, Huazhong University of Science & Technology, Wuhan 430030, PR. China. [7]Shanghai Institute of Respiratory Disease, Respiratory Division of Zhongshan Hospital, Fudan University, Shanghai 200032, PR. China. [8]Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Jilin University, Changchun 130041, Jilin, China. [9]Duke-NUS Medical School, Singapore. [10]School of Life Sciences, University of Technology Sydney, UItimo, NSW, 2007, Australia. [11]Woolcock Institute of Medical Research, The University of Sydney, NSW 2017, [12]Priority Research Center for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW 2305, Australia. [13]Department of Respiratory and Sleep Medicine, John Hunter Hospital, University of Newcastle, Newcastle, NSW 2305, Australia [14]Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410008, China [15]Respiratory Microbiome Laboratory, Frontiers Science Center for Disease-related Molecular Network, Sichuan University, Chengdu 610041, Sichuan, China. [16]National Health and Medical Research Council Center for Excellence in Severe Asthma, Newcastle, NSW 2305, Australia.
出处：
DOI： 10.1016/j.jaip.2023.09.023
ISSN：

关键词： asthma neutrophilic asthma heterogeneity phenotypes cluster analysis phenotype variability

摘要：
Clinical heterogeneity may exist within asthma subtypes defined by inflammatory markers. However, the heterogeneity of neutrophilic asthma (NA) remains largely unexplored.To explore potential clusters and the stability of NA.Participants with NA from the Australasian Severe Asthma Network (ASAN) underwent a multidimensional assessment; they were then asked to participate in a 12-month longitudinal cohort study. We explored potential clusters using a hierarchical cluster analysis and validated the differential future risk of asthma exacerbations in the identified clusters. A decision tree analysis was developed to predict cluster assignments. Finally, the stability of pre-specified clusters was examined within one month.Three clusters were identified in 149 patients with NA. Cluster 1 (n=99, 66.4%) was characterized by "female-predominant non-smokers with well-controlled NA," cluster 2 (n=16, 10.7%) by individuals with "comorbid anxiety/depressive symptoms with poorly controlled NA," and cluster 3 by "older male smokers with late-onset NA." Cluster 2 had a greater proportion of participants with severe exacerbations (P=0.005), hospitalization (P=0.010), and unscheduled visits (P=0.013); and a higher number of emergency visits (P=0.039) than that of the other two clusters. The decision tree assigned 92.6% of the participants correctly. Most participants (87.5%, n=7) in cluster 2 had stable NA phenotype, whereas participants of clusters 1 and 3 had variable phenotypes.We identified three clinical clusters of NA, in which, cluster 2 represents an "uncontrolled" and stable NA subtype with an elevated risk of exacerbations. These findings have clinical implications in the management of NA.Copyright © 2023. Published by Elsevier Inc.

基金：
This study was supported by the National Natural Science Foundation of China (No. 8 1920108002, and 81870027 and 82370044), Science and Technology Bureau of Chengdu City, China (No. 202 1-GH03-00007-HZ), Science and Technology Agency of Sichuan Province, China No.2022YFS0263), Sichuan Science and Technology Program, Sichuan, China (No. 2023NSFSC1455), and 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (201 8HXFH016).
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中科院(CAS)分区：
出版当年[2023]版：
大类 | 1 区 医学
小类 | 1 区 过敏 1 区 免疫学
最新[2025]版：
大类 | 1 区 医学
小类 | 1 区 免疫学 2 区 过敏
JCR分区：
出版当年[2022]版：
Q1 ALLERGY Q1 IMMUNOLOGY
最新[2023]版：
Q1 ALLERGY Q1 IMMUNOLOGY

影响因子： 最新[2023版] 最新五年平均 出版当年[2022版] 出版当年五年平均 出版前一年[2021版] 出版后一年[2023版]

第一作者：
第一作者单位： [1]Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610041, China. [2]State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu 610041, China. [3]Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou, China. [4]Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, Sichuan University, Chengdu 610041, China.
共同第一作者：
通讯作者：
通讯机构： [1]Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610041, China. [2]State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu 610041, China. [4]Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, Sichuan University, Chengdu 610041, China. [15]Respiratory Microbiome Laboratory, Frontiers Science Center for Disease-related Molecular Network, Sichuan University, Chengdu 610041, Sichuan, China. [*1]Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610041, P. R. China [*2]Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610041， P. R. China
推荐引用方式(GB/T 7714)：
He Li Xiu,Deng Ke,Wang Ji,et al.Clinical subtypes of neutrophilic asthma: a cluster analysis from Australasian Severe Asthma Network[J].JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE.2024,12(3):doi:10.1016/j.jaip.2023.09.023.
APA：
He Li Xiu,Deng Ke,Wang Ji,Zhang Xin,Wang Lei...&Gibson Peter Gerard.(2024).Clinical subtypes of neutrophilic asthma: a cluster analysis from Australasian Severe Asthma Network.JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE,12,(3)
MLA：
He Li Xiu,et al."Clinical subtypes of neutrophilic asthma: a cluster analysis from Australasian Severe Asthma Network".JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 12..3(2024)

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