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- Title
Distinct Phenotypes of Smokers with Fixed Airflow Limitation Identified by Cluster Analysis of Severe Asthma.
- Authors
Satoshi Konno; Natsuko Taniguchi; Hironi Makita; Yuji Nakamaru; Kaoruko Shimizu; Noriharu Shijubo; Satoshi Fuke; Kimihiro Takeyabu; Mitsuru Oguri; Hirokazu Kimura; Yukiko Maeda; Masaru Suzuki; Katsura Nagai; Ito, Yoichi M.; Wenzel, Sally E.; Masaharu Nishimura; Konno, Satoshi; Taniguchi, Natsuko; Makita, Hironi; Nakamaru, Yuji
- Abstract
<bold>Rationale: </bold>Smoking may have multifactorial effects on asthma phenotypes, particularly in severe asthma. Cluster analysis has been applied to explore novel phenotypes, which are not based on any a priori hypotheses.<bold>Objectives: </bold>To explore novel severe asthma phenotypes by cluster analysis when including smoking patients with asthma.<bold>Methods: </bold>We recruited a total of 127 subjects with severe asthma, including 59 current or ex-smokers, from our university hospital and its 29 affiliated hospitals/pulmonary clinics. Clinical variables obtained during a 2-day hospital stay were used for cluster analysis. After clustering using clinical variables, the sputum levels of 14 molecules were measured to biologically characterize the clinical clusters.<bold>Results: </bold>Five clinical clusters, including two characterized by low forced expiratory volume in 1 second/forced vital capacity, were identified. When characteristics of smoking subjects in these two clusters were compared, there were marked differences between the two groups: one had high levels of circulating eosinophils, high immunoglobulin E levels, and a high sinus score, and the other was characterized by low levels of the same parameters. Sputum analysis revealed intriguing differences of cytokine/chemokine pattern in these two groups. The other three clusters were similar to those previously reported: young onset/atopic, nonsmoker/less eosinophilic, and female/obese. Key clinical variables were confirmed to be stable and consistent 3 years later.<bold>Conclusions: </bold>This study reveals two distinct phenotypes with potentially different biological pathways contributing to fixed airflow limitation in cigarette smokers with severe asthma.
- Publication
Annals of the American Thoracic Society, 2018, Vol 15, Issue 1, p33
- ISSN
2329-6933
- Publication type
journal article
- DOI
10.1513/AnnalsATS.201701-065OC