Collin R Brooks1, Christine J van Dalen1, Angela Zacharasiewicz2, Jodie L Simpson3,4, Jacquie L Harper5, Graham Le Gros5, Peter G Gibson3, Neil Pearce1,6, Jeroen Douwes1. 1. Centre for Public Health Research, Massey University, Wellington, New Zealand. 2. Department of Pediatrics and Adolescent Medicine, Wilhelminenspital, Vienna, Austria. 3. Respiratory and Sleep Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia. 4. School of Biomedical Science and Pharmacy, Newcastle, New South Wales, Australia. 5. Malaghan Institute of Medical Research, Wellington, New Zealand. 6. Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Abstract
BACKGROUND AND OBJECTIVE: Neutrophilic inflammation has been implicated in non-eosinophilic asthma (NEA) in adults, but little is known about NEA in children/adolescents. We assessed clinical and inflammatory characteristics of NEA in adolescent asthma. METHODS: Airway inflammation, sputum endotoxin, airway hyper-reactivity, atopy and lung function were assessed in 77 adolescents with asthma and 68 without asthma (12-17 years). Asthma was identified on the basis of wheeze and asthma history. RESULTS: The proportion of NEA (sputum eosinophils <2.5%) was 54%. In this group, atopy, sputum neutrophil, eosinophil, eosinophil cationic protein (ECP), endotoxin, neutrophil elastase and IL-8 levels were not different from those without asthma. In contrast, eosinophilic asthma (EA) was associated with atopy and sputum ECP and IL-8. The majority of NEA had no evidence of inflammation; only 14% had neutrophilia (≥61% neutrophils), compared with 11% of EA, and 15% of those without asthma. Small differences in FEV1 (NS) were found between EA and NEA, but symptom prevalence and severity was not different (63% of EA and 52% of NEA were classified moderate to severe). CONCLUSION: NEA is common in adolescent asthma and has similar clinical characteristics as EA. Neutrophils do not appear to play a role in NEA in adolescents, and underlying mechanisms may not involve airway inflammation.
BACKGROUND AND OBJECTIVE:Neutrophilic inflammation has been implicated in non-eosinophilic asthma (NEA) in adults, but little is known about NEA in children/adolescents. We assessed clinical and inflammatory characteristics of NEA in adolescent asthma. METHODS:Airway inflammation, sputum endotoxin, airway hyper-reactivity, atopy and lung function were assessed in 77 adolescents with asthma and 68 without asthma (12-17 years). Asthma was identified on the basis of wheeze and asthma history. RESULTS: The proportion of NEA (sputum eosinophils <2.5%) was 54%. In this group, atopy, sputum neutrophil, eosinophil, eosinophil cationic protein (ECP), endotoxin, neutrophil elastase and IL-8 levels were not different from those without asthma. In contrast, eosinophilic asthma (EA) was associated with atopy and sputum ECP and IL-8. The majority of NEA had no evidence of inflammation; only 14% had neutrophilia (≥61% neutrophils), compared with 11% of EA, and 15% of those without asthma. Small differences in FEV1 (NS) were found between EA and NEA, but symptom prevalence and severity was not different (63% of EA and 52% of NEA were classified moderate to severe). CONCLUSION: NEA is common in adolescent asthma and has similar clinical characteristics as EA. Neutrophils do not appear to play a role in NEA in adolescents, and underlying mechanisms may not involve airway inflammation.
Authors: Jesse P Negherbon; Karina Romero; D'Ann L Williams; Rafael E Guerrero-Preston; Thomas Hartung; Alan L Scott; Patrick N Breysse; William Checkley; Nadia N Hansel Journal: Front Pharmacol Date: 2017-03-30 Impact factor: 5.810
Authors: Lucy Pembrey; Mauricio L Barreto; Jeroen Douwes; Philip Cooper; John Henderson; Harriet Mpairwe; Cristina Ardura-Garcia; Martha Chico; Collin Brooks; Alvaro A Cruz; Alison M Elliott; Camila A Figueiredo; Sinéad M Langan; Beatrice Nassanga; Susan Ring; Laura Rodrigues; Neil Pearce Journal: ERJ Open Res Date: 2018-08-22
Authors: Francis Nissen; Ian J Douglas; Hana Müllerová; Neil Pearce; Chloe I Bloom; Liam Smeeth; Jennifer K Quint Journal: J Asthma Allergy Date: 2019-01-08
Authors: Kenneth P Hough; Miranda L Curtiss; Trevor J Blain; Rui-Ming Liu; Jennifer Trevor; Jessy S Deshane; Victor J Thannickal Journal: Front Med (Lausanne) Date: 2020-05-21
Authors: Hajar Ali; Collin Brooks; Julian Crane; Richard Beasley; Stephen Holgate; Peter Gibson; Philip Pattemore; Yu-Chieh Tzeng; Thorsten Stanley; Neil Pearce; Jeroen Douwes Journal: BMJ Open Respir Res Date: 2021-11