机构：[1]Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing 100730, China.首都医科大学附属北京同仁医院临床科室呼吸与危重症医学科[2]Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China.首都医科大学附属北京同仁医院研究所耳鼻咽喉科研究所[3]Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.医技科室放射科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[4]Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing 100730, China.临床科室耳鼻咽喉-头颈外科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[5]Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.临床科室变态反应科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[6]Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Background Asthma is significantly related to chronic rhinosinusitis (CRS) both in prevalence and severity. However, the clinical patterns of uncontrolled asthma with and without comorbid CRS are still unclear. This study aimed to explore the clinical characteristics and cytokine patterns of patients with uncontrolled asthma, with and without comorbid CRS. Methods 22 parameters associated with demographic characteristics, CRS comorbidity, severity of airflow obstruction and airway inflammation, and inflammation type of asthma were collected and assessed in 143 patients with uncontrolled asthma. Different clusters were explored using two-step cluster analysis. Sputum samples were collected for assessment of Th1/Th2/Th17 and epithelium-derived cytokines. Results Comorbid CRS was identified as the most important variable for prediction of different clusters, followed by pulmonary function parameters and blood eosinophil level. Three clusters of patients were determined: Cluster 1 (n = 46) characterized by non-atopic patients with non-eosinophilic asthma without CRS, demonstrating moderate airflow limitation; Cluster 2 (n = 54) characterized by asthma patients with mild airflow limitation and CRS, demonstrating higher levels of blood eosinophils and immunoglobulin E (IgE) than cluster 1; Cluster 3 (n = 43) characterized by eosinophilic asthma patients with severe airflow limitation and CRS (46.5% with nasal polyps), demonstrating worst lung function, lowest partial pressure of oxygen (PaO2), and highest levels of eosinophils, fraction of exhaled nitric oxide (FeNO) and IgE. Sputum samples from Cluster 3 showed significantly higher levels of Interleukin (IL)-5, IL-13, IL-33, and tumor necrosis factor (TNF)-alpha than the other two clusters; and remarkably elevated IL-4, IL-17 and interferon (IFN)-gamma compared with cluster 2. The levels of IL-10 and IL-25 were not significantly different among the three clusters. Conclusions Uncontrolled asthma may be endotyped into three clusters characterized by CRS comorbidity and inflammatory cytokine patterns. Furthermore, a united-airways approach may be especially necessary for management of asthma patients with Type 2 features.
基金：
This work was supported by grants from CAMS Innovation Fund for Medical
Sciences (2019-12M-5-022), the program for Changjiang Scholars and Innovative
Research Team (IRT13082), National Natural Science Foundation of China
(81100704, 81441029, 81441031, 81570894, 81400444, and 81470678), Capital
Health Development Foundation (2016-1-2052), Beijing Municipal Science
and Technology Project (Z181100001618002), High-level Talent Training Foundation
of Beijing Health System (2014-3-011), and Natural Science Cultivation
Fund of Beijing Tongren Hospital (2021-YJJ-ZR-015).
第一作者机构：[1]Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing 100730, China.
通讯作者：
通讯机构：[1]Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing 100730, China.[2]Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China.[4]Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, No. 1, DongJiaoMinXiang, DongCheng District, Beijing 100730, China.[5]Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.[6]Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China.
推荐引用方式(GB/T 7714)：
Huang Kai,Li Fangyuan,Wang Xuechen,et al.Clinical and cytokine patterns of uncontrolled asthma with and without comorbid chronic rhinosinusitis: a cross-sectional study[J].RESPIRATORY RESEARCH.2022,23(1):doi:10.1186/s12931-022-02028-3.
APA：
Huang, Kai,Li, Fangyuan,Wang, Xuechen,Yan, Bing,Wang, Ming...&Zhang, Luo.(2022).Clinical and cytokine patterns of uncontrolled asthma with and without comorbid chronic rhinosinusitis: a cross-sectional study.RESPIRATORY RESEARCH,23,(1)
MLA：
Huang, Kai,et al."Clinical and cytokine patterns of uncontrolled asthma with and without comorbid chronic rhinosinusitis: a cross-sectional study".RESPIRATORY RESEARCH 23..1(2022)
