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- Title
Absence of airway inflammation in a large proportion of adolescents with asthma.
- Authors
Brooks, Collin R.; Dalen, Christine J.; Zacharasiewicz, Angela; Simpson, Jodie L.; Harper, Jacquie L.; Le Gros, Graham; Gibson, Peter G.; Pearce, Neil; Douwes, Jeroen
- Abstract
Background and objective Neutrophilic inflammation has been implicated in non-eosinophilic asthma ( NEA) in adults, but little is known about NEA in children/adolescents. We assessed clinical and inflammatory characteristics of NEA in adolescent asthma. Methods Airway inflammation, sputum endotoxin, airway hyper-reactivity, atopy and lung function were assessed in 77 adolescents with asthma and 68 without asthma (12-17 years). Asthma was identified on the basis of wheeze and asthma history. Results The proportion of NEA (sputum eosinophils <2.5%) was 54%. In this group, atopy, sputum neutrophil, eosinophil, eosinophil cationic protein ( ECP), endotoxin, neutrophil elastase and IL-8 levels were not different from those without asthma. In contrast, eosinophilic asthma ( EA) was associated with atopy and sputum ECP and IL-8. The majority of NEA had no evidence of inflammation; only 14% had neutrophilia (≥61% neutrophils), compared with 11% of EA, and 15% of those without asthma. Small differences in FEV1 ( NS) were found between EA and NEA, but symptom prevalence and severity was not different (63% of EA and 52% of NEA were classified moderate to severe). Conclusion NEA is common in adolescent asthma and has similar clinical characteristics as EA. Neutrophils do not appear to play a role in NEA in adolescents, and underlying mechanisms may not involve airway inflammation.
- Subjects
NEUTROPHILS; ASTHMA; AIRWAY (Anatomy); EOSINOPHILS; ENDOTOXINS
- Publication
Respirology, 2016, Vol 21, Issue 3, p460
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.12701