Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital

Airway hyperresponsiveness to inhaled mannitol identifies a cluster of non-eosinophilic asthma patients with high symptom burden

Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review


  1. Reliability of early and late testing for suspected perioperative hypersensitivity

    Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review

  2. Defining a Severe Asthma Super-Responder: Findings from a Delphi Process

    Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review

  3. Mast Cell Activation During Suspected Perioperative Hypersensitivity: A Need for Paired Samples Analysis

    Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review

Vis graf over relationer

BACKGROUND: Patients with asthma are heterogeneous in clinical presentation and in response to treatment. Despite this, tools to guide treatment are limited and include mainly measures of eosinophilic inflammation and symptoms. Airway hyperresponsiveness (AHR) to mannitol is present in patients across inflammatory phenotypes and improve with inhaled corticosteroids.

OBJECTIVE: To investigate whether measuring AHR to mannitol in addition to eosinophilic inflammation and symptoms adds information to the phenotypic characterization of patients with asthma.

METHODS: A total of 317 patients with asthma from 6 different cohorts were included in the analysis. All patients had measures of AHR to mannitol, blood eosinophils, and Asthma Control Questionnaire 5 available. A cluster analysis using Ward minimum variance method was performed. The distribution of fraction of exhaled nitric oxide, immunoglobulin E, lung function, induced sputum inflammatory cell count, age of onset, and severity of disease was compared between clusters.

RESULTS: Four clusters were identified. Three of the clusters had proportionate levels of AHR, eosinophilic inflammation, and symptoms, but 1 cluster presented with low levels of eosinophilic inflammation and a significant symptom burden. Half of the subjects in this cluster presented with AHR to inhaled mannitol. Lung function, fraction of exhaled nitric oxide, body mass index, and immunoglobulin E were normal.

CONCLUSIONS: Information on AHR to mannitol in addition to blood eosinophils and symptoms identifies a subgroup of asthma patients with symptomatic, noneosinophilic disease. Airway hyperresponsiveness to mannitol may provide a treatable trait in a subgroup of patients with noneosinophilic asthma.

TidsskriftThe journal of allergy and clinical immunology. In practice
Udgave nummer11
Sider (fra-til)4029-4036.e2
Antal sider8
StatusUdgivet - nov. 2021

ID: 66949961