Trung N Tran1, Robert S Zeiger2, Stephen P Peters3, Gene Colice4, Paul Newbold5, Mitchell Goldman4, Bradley E Chipps6. 1. Global Medicine Development, AstraZeneca, Gaithersburg, Maryland. Electronic address: trantr@medimmune.com. 2. Kaiser Permanente Southern California, San Diego, California. 3. Wake Forest School of Medicine, Winston-Salem, North Carolina. 4. Global Medicine Development, AstraZeneca, Gaithersburg, Maryland. 5. Translational Medicine, MedImmune, Gaithersburg, Maryland. 6. Capital Allergy & Respiratory Disease Center, Sacramento, California.
Abstract
BACKGROUND: Atopic, eosinophilic, and TH2-high asthma phenotypes may overlap, but the extent is unknown. Understanding the overlap across these phenotypes may be useful in guiding asthma patient care. OBJECTIVE: To examine the frequency and overlap of atopic, eosinophilic, and TH2-high asthma phenotypes. METHODS: We analyzed 2005 to 2006 data from the National Health and Nutrition Examination Survey. Patients with asthma were identified based on the participant self-report. Eosinophilic asthma was defined as a blood eosinophil cutoff point of ≥150, 300, or 400/μL. Atopic asthma was defined as having an allergen-specific IgE level of ≥0.35 IU/mL for any of the 9 perennial allergens tested. TH2-high asthma was defined as a total serum IgE of ≥100 IU/mL and a blood eosinophil count of ≥140/μL. RESULTS: The study included 269 children and 310 adults. Depending on the eosinophil cutoff used, 31% to 78% of children and 21% to 69% of adults with asthma were classified as having eosinophilic asthma. In addition, 63% of children and 61% of adults were classified as having atopic disease and 48% of children and 37% of adults as having TH2-high asthma. At a higher eosinophil cutoff point, a greater proportion of eosinophilic asthma can be classified as atopic or TH2 high, but a lower proportion of atopic or TH2-high asthma can be classified as eosinophilic. Approximately 70% or more of children and adults with asthma were 1 of these 3 phenotypes. CONCLUSION: A considerable overlap among eosinophilic, atopic, and TH2-high asthma phenotypes exists in a general asthma population.
BACKGROUND: Atopic, eosinophilic, and TH2-high asthma phenotypes may overlap, but the extent is unknown. Understanding the overlap across these phenotypes may be useful in guiding asthma patient care. OBJECTIVE: To examine the frequency and overlap of atopic, eosinophilic, and TH2-high asthma phenotypes. METHODS: We analyzed 2005 to 2006 data from the National Health and Nutrition Examination Survey. Patients with asthma were identified based on the participant self-report. Eosinophilic asthma was defined as a blood eosinophil cutoff point of ≥150, 300, or 400/μL. Atopic asthma was defined as having an allergen-specific IgE level of ≥0.35 IU/mL for any of the 9 perennial allergens tested. TH2-high asthma was defined as a total serum IgE of ≥100 IU/mL and a blood eosinophil count of ≥140/μL. RESULTS: The study included 269 children and 310 adults. Depending on the eosinophil cutoff used, 31% to 78% of children and 21% to 69% of adults with asthma were classified as having eosinophilic asthma. In addition, 63% of children and 61% of adults were classified as having atopic disease and 48% of children and 37% of adults as having TH2-high asthma. At a higher eosinophil cutoff point, a greater proportion of eosinophilic asthma can be classified as atopic or TH2 high, but a lower proportion of atopic or TH2-high asthma can be classified as eosinophilic. Approximately 70% or more of children and adults with asthma were 1 of these 3 phenotypes. CONCLUSION: A considerable overlap among eosinophilic, atopic, and TH2-high asthma phenotypes exists in a general asthma population.
Authors: Andrew Menzies-Gow; David J Jackson; Mona Al-Ahmad; Eugene R Bleecker; Francisco de Borja G Cosio Piqueras; Stephen Brunton; Giorgio Walter Canonica; Charles K N Chan; John Haughney; Steve Holmes; Janwillem Kocks; Tonya Winders Journal: Adv Ther Date: 2022-10-17 Impact factor: 4.070
Authors: Moritz Z Kayser; Nora Drick; Katrin Milger; Jan Fuge; Nikolaus Kneidinger; Stephanie Korn; Roland Buhl; Jürgen Behr; Tobias Welte; Hendrik Suhling Journal: J Asthma Allergy Date: 2021-07-12