Type 2 Low Biomarker Stability and Exacerbations in Severe Uncontrolled Asthma
We investigated the stability of T2 low status, based on low levels of T2 biomarkers, and exacerbation rates in T2 low and non-T2 low asthma from clinical retrospective data of severe uncontrolled asthma patients. Knowledge of the T2 low biomarker profile is sparse and biomarker stability is unchart...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-07-01
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| Series: | Biomolecules |
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| Online Access: | https://www.mdpi.com/2218-273X/13/7/1118 |
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| author | Arja Viinanen Juhani Aakko Mariann I. Lassenius Gunilla Telg Kaisa Nieminen Saara Kaijala Lauri Lehtimäki Hannu Kankaanranta |
| author_facet | Arja Viinanen Juhani Aakko Mariann I. Lassenius Gunilla Telg Kaisa Nieminen Saara Kaijala Lauri Lehtimäki Hannu Kankaanranta |
| author_sort | Arja Viinanen |
| collection | DOAJ |
| description | We investigated the stability of T2 low status, based on low levels of T2 biomarkers, and exacerbation rates in T2 low and non-T2 low asthma from clinical retrospective data of severe uncontrolled asthma patients. Knowledge of the T2 low biomarker profile is sparse and biomarker stability is uncharted. Secondary care patients with severe uncontrolled asthma and at least two blood eosinophil counts (BEC) and fractional exhaled nitric oxide (FeNO) measured for determination of type 2 inflammation status were evaluated from a follow-up period of 4 years. Patients were stratified into four groups: T2 low<sub>150</sub> (<i>n</i> = 31; BEC < 150 cells/µL and FeNO < 25 ppb), non-T2 low<sub>150</sub> (<i>n</i> = 138; BEC > 150 cells/µL and/or FeNO > 25 ppb), T2 low<sub>300</sub> (<i>n</i> = 66; BEC < 300 cells/µL and FeNO < 25 ppb), and non-T2 low<sub>300</sub> (<i>n</i> = 103; BEC > 300 cells/µL and/or FeNO > 25 ppb). Exacerbation rates requiring hospital care, stability of biomarker status, and cumulative OCS and ICS doses were assessed during follow-up. Among patients with severe uncontrolled asthma, 18% (<i>n</i> = 31) were identified as T2 low<sub>150</sub>, and 39% (<i>n</i> = 66) as T2 low<sub>300</sub>. In these groups, the low biomarker profile was stable in 55% (<i>n</i> = 11) and 72% (<i>n</i> = 33) of patients with follow-up measures. Exacerbation rates were different between the T2 low and non-T2 low groups: 19.7 [95% CI: 4.3–45.6] in T2 low<sub>150</sub> vs. 8.4 [4.7–13.0] in non-T2 low<sub>150</sub> per 100 patient-years. BEC and FeNO are useful biomarkers in identifying T2 low severe uncontrolled asthma, showing a stable follow-up biomarker profile in up to 72% of patients. Repeated monitoring of these biomarkers is essential in identifying and treating patients with T2 low asthma. |
| first_indexed | 2024-03-11T01:15:48Z |
| format | Article |
| id | doaj.art-9bf38237e3014a21b4dd18bf700cf616 |
| institution | Directory Open Access Journal |
| issn | 2218-273X |
| language | English |
| last_indexed | 2024-03-11T01:15:48Z |
| publishDate | 2023-07-01 |
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| series | Biomolecules |
| spelling | doaj.art-9bf38237e3014a21b4dd18bf700cf6162023-11-18T18:31:41ZengMDPI AGBiomolecules2218-273X2023-07-01137111810.3390/biom13071118Type 2 Low Biomarker Stability and Exacerbations in Severe Uncontrolled AsthmaArja Viinanen0Juhani Aakko1Mariann I. Lassenius2Gunilla Telg3Kaisa Nieminen4Saara Kaijala5Lauri Lehtimäki6Hannu Kankaanranta7Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, 20014 Turku, FinlandMedaffcon Oy, 02130 Espoo, FinlandMedaffcon Oy, 02130 Espoo, FinlandAstraZeneca, 51 85 Stockholm, SwedenAstraZeneca, 02150 Espoo, FinlandMedaffcon Oy, 02130 Espoo, FinlandAllergy Centre, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, FinlandKrefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 417 56 Gothenburg, SwedenWe investigated the stability of T2 low status, based on low levels of T2 biomarkers, and exacerbation rates in T2 low and non-T2 low asthma from clinical retrospective data of severe uncontrolled asthma patients. Knowledge of the T2 low biomarker profile is sparse and biomarker stability is uncharted. Secondary care patients with severe uncontrolled asthma and at least two blood eosinophil counts (BEC) and fractional exhaled nitric oxide (FeNO) measured for determination of type 2 inflammation status were evaluated from a follow-up period of 4 years. Patients were stratified into four groups: T2 low<sub>150</sub> (<i>n</i> = 31; BEC < 150 cells/µL and FeNO < 25 ppb), non-T2 low<sub>150</sub> (<i>n</i> = 138; BEC > 150 cells/µL and/or FeNO > 25 ppb), T2 low<sub>300</sub> (<i>n</i> = 66; BEC < 300 cells/µL and FeNO < 25 ppb), and non-T2 low<sub>300</sub> (<i>n</i> = 103; BEC > 300 cells/µL and/or FeNO > 25 ppb). Exacerbation rates requiring hospital care, stability of biomarker status, and cumulative OCS and ICS doses were assessed during follow-up. Among patients with severe uncontrolled asthma, 18% (<i>n</i> = 31) were identified as T2 low<sub>150</sub>, and 39% (<i>n</i> = 66) as T2 low<sub>300</sub>. In these groups, the low biomarker profile was stable in 55% (<i>n</i> = 11) and 72% (<i>n</i> = 33) of patients with follow-up measures. Exacerbation rates were different between the T2 low and non-T2 low groups: 19.7 [95% CI: 4.3–45.6] in T2 low<sub>150</sub> vs. 8.4 [4.7–13.0] in non-T2 low<sub>150</sub> per 100 patient-years. BEC and FeNO are useful biomarkers in identifying T2 low severe uncontrolled asthma, showing a stable follow-up biomarker profile in up to 72% of patients. Repeated monitoring of these biomarkers is essential in identifying and treating patients with T2 low asthma.https://www.mdpi.com/2218-273X/13/7/1118severe uncontrolled asthmatype 2 lowblood eosinophilsfractional exhaled nitric oxideexacerbationsadults |
| spellingShingle | Arja Viinanen Juhani Aakko Mariann I. Lassenius Gunilla Telg Kaisa Nieminen Saara Kaijala Lauri Lehtimäki Hannu Kankaanranta Type 2 Low Biomarker Stability and Exacerbations in Severe Uncontrolled Asthma Biomolecules severe uncontrolled asthma type 2 low blood eosinophils fractional exhaled nitric oxide exacerbations adults |
| title | Type 2 Low Biomarker Stability and Exacerbations in Severe Uncontrolled Asthma |
| title_full | Type 2 Low Biomarker Stability and Exacerbations in Severe Uncontrolled Asthma |
| title_fullStr | Type 2 Low Biomarker Stability and Exacerbations in Severe Uncontrolled Asthma |
| title_full_unstemmed | Type 2 Low Biomarker Stability and Exacerbations in Severe Uncontrolled Asthma |
| title_short | Type 2 Low Biomarker Stability and Exacerbations in Severe Uncontrolled Asthma |
| title_sort | type 2 low biomarker stability and exacerbations in severe uncontrolled asthma |
| topic | severe uncontrolled asthma type 2 low blood eosinophils fractional exhaled nitric oxide exacerbations adults |
| url | https://www.mdpi.com/2218-273X/13/7/1118 |
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