T2-High Endotype and Response to Biological Treatments in Patients with <i>Bronchiectasis</i>
Although bronchiectasis pathophysiology has been historically understood around the presence of airway neutrophilic inflammation, recent experiences are consistent with the identification of a type 2 inflammation (T2) high endotype in bronchiectasis. In order to evaluate prevalence and clinical char...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-07-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/9/7/772 |
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| author | Martina Oriano Andrea Gramegna Francesco Amati Alice D’Adda Michele Gaffuri Marco Contoli Francesco Bindo Edoardo Simonetta Carlotta Di Francesco Martina Santambrogio Giovanni Sotgiu Francesco Blasi Stefano Aliberti |
| author_facet | Martina Oriano Andrea Gramegna Francesco Amati Alice D’Adda Michele Gaffuri Marco Contoli Francesco Bindo Edoardo Simonetta Carlotta Di Francesco Martina Santambrogio Giovanni Sotgiu Francesco Blasi Stefano Aliberti |
| author_sort | Martina Oriano |
| collection | DOAJ |
| description | Although bronchiectasis pathophysiology has been historically understood around the presence of airway neutrophilic inflammation, recent experiences are consistent with the identification of a type 2 inflammation (T2) high endotype in bronchiectasis. In order to evaluate prevalence and clinical characteristics of bronchiectasis patients with a T2-high endotype and explore their response to biologicals, two studies were carried out. In a cross-sectional study, bronchiectasis adults without asthma underwent clinical, radiological, and microbiological assessment, along with blood eosinophils and oral fractional exhaled nitric oxide (FeNO) evaluation, during stable state. Prevalence and characteristics of patients with a T2- high endotype (defined by the presence of either eosinophils blood count ≥300 cells·µL<sup>−1</sup> or oral FeNO ≥ 25 dpp) were reported. A case series of severe asthmatic patients with concomitant bronchiectasis treated with either mepolizumab or benralizumab was evaluated, and patients’ clinical data pre- and post-treatment were analyzed up to 2 years of follow up. Among bronchiectasis patients without asthma enrolled in the cross-sectional study, a T2-high endotype was present in 31% of them. These patients exhibited a more severe disease, high dyspnea severity, low respiratory function, and high impact on quality of life. Among the five patients with severe eosinophilic asthma and concomitant bronchiectasis included in the series, treatment with either mepolizumab or benralizumab significantly reduced the exacerbation rate with an effect that persists for up to 2 years of follow up. If validated across different settings, our data suggest the need to design randomized controlled trials on biological treatments targeting the T2-high endotype in bronchiectasis patients. |
| first_indexed | 2024-03-10T09:44:39Z |
| format | Article |
| id | doaj.art-0ccca8e2bfa044ca86939d020ad5f10f |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-10T09:44:39Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-0ccca8e2bfa044ca86939d020ad5f10f2023-11-22T03:16:45ZengMDPI AGBiomedicines2227-90592021-07-019777210.3390/biomedicines9070772T2-High Endotype and Response to Biological Treatments in Patients with <i>Bronchiectasis</i>Martina Oriano0Andrea Gramegna1Francesco Amati2Alice D’Adda3Michele Gaffuri4Marco Contoli5Francesco Bindo6Edoardo Simonetta7Carlotta Di Francesco8Martina Santambrogio9Giovanni Sotgiu10Francesco Blasi11Stefano Aliberti12IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, 20122 Milan, ItalyIRCCS Ca’ Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, 20122 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, ItalyIRCCS Ca’ Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, 20122 Milan, ItalyFondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Otolaryngology and Head and Neck Surgery, 20122 Milan, ItalyRespiratory Unit, Department of Translational Medicine, University of Ferrara, 44121 Ferrara, ItalyIRCCS Ca’ Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, 20122 Milan, ItalyIRCCS Ca’ Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, 20122 Milan, ItalyIRCCS Ca’ Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, 20122 Milan, ItalyIRCCS Ca’ Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, 20122 Milan, ItalyClinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, ItalyIRCCS Ca’ Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, 20122 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, ItalyAlthough bronchiectasis pathophysiology has been historically understood around the presence of airway neutrophilic inflammation, recent experiences are consistent with the identification of a type 2 inflammation (T2) high endotype in bronchiectasis. In order to evaluate prevalence and clinical characteristics of bronchiectasis patients with a T2-high endotype and explore their response to biologicals, two studies were carried out. In a cross-sectional study, bronchiectasis adults without asthma underwent clinical, radiological, and microbiological assessment, along with blood eosinophils and oral fractional exhaled nitric oxide (FeNO) evaluation, during stable state. Prevalence and characteristics of patients with a T2- high endotype (defined by the presence of either eosinophils blood count ≥300 cells·µL<sup>−1</sup> or oral FeNO ≥ 25 dpp) were reported. A case series of severe asthmatic patients with concomitant bronchiectasis treated with either mepolizumab or benralizumab was evaluated, and patients’ clinical data pre- and post-treatment were analyzed up to 2 years of follow up. Among bronchiectasis patients without asthma enrolled in the cross-sectional study, a T2-high endotype was present in 31% of them. These patients exhibited a more severe disease, high dyspnea severity, low respiratory function, and high impact on quality of life. Among the five patients with severe eosinophilic asthma and concomitant bronchiectasis included in the series, treatment with either mepolizumab or benralizumab significantly reduced the exacerbation rate with an effect that persists for up to 2 years of follow up. If validated across different settings, our data suggest the need to design randomized controlled trials on biological treatments targeting the T2-high endotype in bronchiectasis patients.https://www.mdpi.com/2227-9059/9/7/772BronchiectasisT2-hightype 2 inflammationeosinophilia |
| spellingShingle | Martina Oriano Andrea Gramegna Francesco Amati Alice D’Adda Michele Gaffuri Marco Contoli Francesco Bindo Edoardo Simonetta Carlotta Di Francesco Martina Santambrogio Giovanni Sotgiu Francesco Blasi Stefano Aliberti T2-High Endotype and Response to Biological Treatments in Patients with <i>Bronchiectasis</i> Biomedicines Bronchiectasis T2-high type 2 inflammation eosinophilia |
| title | T2-High Endotype and Response to Biological Treatments in Patients with <i>Bronchiectasis</i> |
| title_full | T2-High Endotype and Response to Biological Treatments in Patients with <i>Bronchiectasis</i> |
| title_fullStr | T2-High Endotype and Response to Biological Treatments in Patients with <i>Bronchiectasis</i> |
| title_full_unstemmed | T2-High Endotype and Response to Biological Treatments in Patients with <i>Bronchiectasis</i> |
| title_short | T2-High Endotype and Response to Biological Treatments in Patients with <i>Bronchiectasis</i> |
| title_sort | t2 high endotype and response to biological treatments in patients with i bronchiectasis i |
| topic | Bronchiectasis T2-high type 2 inflammation eosinophilia |
| url | https://www.mdpi.com/2227-9059/9/7/772 |
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