title: Eosinophilic and Neutrophilic Airway Inflammation in the Phenotyping of Mild-to-Moderate Asthma and Chronic Obstructive Pulmonary Disease.
abstract: Asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous diseases with different inflammatory phenotypes. Various inflammatory mediators play a role in these diseases. The aim of this study was to analyze the neutrophilic and eosinophilic airway and systemic inflammation as the phenotypic characterization of patients with asthma and COPD. Twenty-four patients with asthma and 33 patients with COPD were enrolled in the study. All the patients were in mild-to-moderate stage of disease, and none of them were treated with inhaled corticosteroids. Concentrations of IL-6, neutrophil elastase (NE), matrix metalloproteinase 9 (MMP-9), eosinophil cationic protein (ECP), and IL-33 and IL-17 in serum and induced sputum (IS) were measured by enzyme-linked immunosorbent assay (ELISA). The cellular composition of blood and IS was evaluated. Hierarchical clustering of patients was performed for the combination of selected clinical features and mediators. Asthma and COPD can be differentiated based on eosinophilic/neutrophilic systemic or airway inflammation with unsatisfactory efficiency. Hierarchical clustering of patients based on blood eosinophil percentage and clinical data revealed two asthma clusters differing in the number of positive skin prick tests and one COPD cluster with two subclusters characterized by low and high blood eosinophil concentrations. Clustering of patients according to IS measurements and clinical data showed two main clusters: pure asthma characterized by high eosinophil/atopy status and mixed asthma and COPD cluster with low eosinophil/atopy status. The neutrophilic phenotype of COPD was associated with more severe airway obstruction and hyperinflation.
authors.affiliation: a Department of Internal Medicine, Pneumonology and Allergology , Medical University of Warsaw , Warsaw , Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Górska
authors.affiliation: a Department of Internal Medicine, Pneumonology and Allergology , Medical University of Warsaw , Warsaw , Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Paplińska-Goryca
authors.affiliation: a Department of Internal Medicine, Pneumonology and Allergology , Medical University of Warsaw , Warsaw , Poland.
authors.forename: Patrycja
authors.initials: P
authors.lastname: Nejman-Gryz
authors.affiliation: b Department of Genetics , Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology , Warsaw , Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Goryca
authors.affiliation: a Department of Internal Medicine, Pneumonology and Allergology , Medical University of Warsaw , Warsaw , Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Krenke
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000097:blood* / Q000276:immunology / Q000378:metabolism; D003430:Cross-Sectional Studies; D047150:Eosinophil Cationic Protein / Q000378:metabolism; D004802:Eosinophilia / Q000097:blood; D004804:Eosinophils; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D016130:Immunophenotyping; D007249:Inflammation / Q000097:blood* / Q000378:metabolism; D020381:Interleukin-17 / Q000378:metabolism; D000067596:Interleukin-33 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D007958:Leukocyte Count; D019272:Leukocyte Elastase / Q000378:metabolism; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D008875:Middle Aged; D009504:Neutrophils; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000276:immunology / Q000378:metabolism; D012372:ROC Curve; D012720:Severity of Illness Index; D013183:Sputum / Q000166:cytology / Q000378:metabolism*; D014797:Vital Capacity
chemical_list: D020381:Interleukin-17; D000067596:Interleukin-33; D015850:Interleukin-6; D047150:Eosinophil Cationic Protein; D019272:Leukocyte Elastase; D020780:Matrix Metalloproteinase 9
keywords: Atopy; IL-6; MMP-9; clustering; obstructive lung diseases