title: Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort.
abstract: U-BIOPRED is a European Union consortium of 20 academic institutions, 11 pharmaceutical companies and six patient organisations with the objective of improving the understanding of asthma disease mechanisms using a systems biology approach.This cross-sectional assessment of adults with severe asthma, mild/moderate asthma and healthy controls from 11 European countries consisted of analyses of patient-reported outcomes, lung function, blood and airway inflammatory measurements.Patients with severe asthma (nonsmokers, n=311; smokers/ex-smokers, n=110) had more symptoms and exacerbations compared to patients with mild/moderate disease (n=88) (2.5 exacerbations versus 0.4 in the preceding 12 months; p<0.001), with worse quality of life, and higher levels of anxiety and depression. They also had a higher incidence of nasal polyps and gastro-oesophageal reflux with lower lung function. Sputum eosinophil count was higher in severe asthma compared to mild/moderate asthma (median count 2.99% versus 1.05%; p=0.004) despite treatment with higher doses of inhaled and/or oral corticosteroids.Consistent with other severe asthma cohorts, U-BIOPRED is characterised by poor symptom control, increased comorbidity and airway inflammation, despite high levels of treatment. It is well suited to identify asthma phenotypes using the array of "omic" datasets that are at the core of this systems medicine approach.
authors.affiliation: Respiratory Research Unit, University of Nottingham, Nottingham, UK Joint first authors dominic.shaw@nottingham.ac.uk.
authors.forename: Dominick E
authors.initials: DE
authors.lastname: Shaw
authors.affiliation: Respiratory Therapeutic Unit, GSK, Stockley Park, UK Joint first authors.
authors.forename: Ana R
authors.initials: AR
authors.lastname: Sousa
authors.affiliation: Respiratory and Allergy Research Group, University of Manchester, Manchester, UK.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Fowler
authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: Louise J
authors.initials: LJ
authors.lastname: Fleming
authors.affiliation: NIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences and Human Development and Health, Southampton, UK Faculty of Medicine, University of Southampton, Southampton, UK The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK.
authors.forename: Graham
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authors.lastname: Roberts
authors.affiliation: AstraZeneca R&D, Mölndal, Sweden Areteva R&D, Nottingham, UK.
authors.forename: Julie
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authors.lastname: Corfield
authors.affiliation: Data Science Institute, South Kensington Campus, Imperial College London, London, UK.
authors.forename: Ioannis
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authors.affiliation: Acclarogen Ltd, St John's Innovation Centre, Cambridge, UK.
authors.forename: Aruna T
authors.initials: AT
authors.lastname: Bansal
authors.affiliation: Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Elisabeth H
authors.initials: EH
authors.lastname: Bel
authors.affiliation: European Institute for Systems Biology and Medicine, CNRS-ENS-UCBL, Université de Lyon, Lyon, France.
authors.forename: Charles
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authors.lastname: Auffray
authors.affiliation: Respiratory Therapeutic Unit, GSK, Stockley Park, UK.
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authors.initials: CH
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authors.affiliation: Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Hans
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authors.affiliation: Chiesi Pharmacueticals SPA, Parma, Italy.
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authors.forename: Massimo
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authors.affiliation: Département des Maladies Respiratoires, Laboratoire d'immunologie, Aix Marseille Université Marseille, Marseille, France.
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authors.affiliation: Lung/Allergy Clinic, Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors.forename: Barbro
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authors.affiliation: The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sven-Erik
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authors.affiliation: CROMSOURCE, Stirling, UK.
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authors.affiliation: University Children's Hospital Basel, Basel, Switzerland.
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authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK.
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authors.affiliation: Data Science Institute, South Kensington Campus, Imperial College London, London, UK.
authors.forename: Yi-Ke
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authors.affiliation: Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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authors.affiliation: Dept of Women's and Children's Health and Center for Allergy Research, Karolinska Institutet, Stockholm, Sweden.
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authors.lastname: Hedlin
authors.affiliation: UK Clinical Operations, GSK, Stockley Park, UK.
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authors.affiliation: Dept of Pulmonology, Semmelweis University, Budapest, Hungary.
authors.forename: Ildikó
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authors.affiliation: Respiratory Research Unit, University of Nottingham, Nottingham, UK.
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authors.affiliation: Lung/Allergy Clinic, Karolinska University Hospital Huddinge, Stockholm, Sweden.
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authors.affiliation: Boehringer Ingelheim Pharma GmbH & Co., Ingelheim, Germany.
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authors.affiliation: University Hospital Bern, Bern, Switzerland Tiefenau Hospital, Bern, Switzerland.
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authors.affiliation: Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Ariane H
authors.initials: AH
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authors.affiliation: NIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
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authors.affiliation: Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Joint last authors.
authors.forename: Peter J
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authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK Joint last authors.
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mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001007:Anxiety / Q000453:epidemiology; D001249:Asthma / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005060:Europe; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D013147:Spirometry; D011795:Surveys and Questionnaires; D049490:Systems Biology
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D009569:Nitric Oxide