Suárez-Cuartín Guillermo, Crespo Astrid, Mateus Eder, Torrejón Montserrat, Giner Jordi, Belda Alicia, Ramos-Barbón David, Torrego Alfons, Plaza Vicente
Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, España.
Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, España.
Arch Bronconeumol. 2016 Feb;52(2):76-81. doi: 10.1016/j.arbres.2015.03.007. Epub 2015 May 4.
Recent studies have found variability in asthma inflammatory phenotypes determined by the inflammatory cells in induced sputum (IS). The aim of this study was to determine the frequency and factors affecting inflammatory phenotype variability in IS.
Retrospective observational study that included 61 asthmatic patients who underwent at least two IS tests over a period of 5 years. They were classified according to their baseline inflammatory phenotype and subsequently grouped according to phenotype variability (persistent eosinophilic, persistent non-eosinophilic and intermittent eosinophilic). Demographic, clinical and functional data and factors potentially influencing IS variability were collected in all cases.
Of the 61 patients, 31 (50.8%) had a change with respect to baseline inflammatory phenotype. Of these, 16 (51.6%) were eosinophilic, 5 (16.1%) neutrophilic, 1 (3.2%) mixed and 9 (29.1%) paucigranulocytic. According to phenotype variability, 18 patients (29.5%) were classified as persistent eosinophilic, 17 (27.9%) non-persistent eosinophilic, and 26 (42.6%) intermittent eosinophilic. Smoking and recent asthma exacerbation were significantly associated with increased risk of variability of the IS inflammatory phenotype (OR=6.44; p=.013; 95% CI=1.49-27.80 and OR=5.84; p=.022; 95% CI=1.29-26.37, respectively).
Half of asthma patients, predominantly those with eosinophilic phenotype, present a change in IS inflammatory phenotype. This variability is associated with smoking and recent asthma exacerbation. Data suggest these factors can modify the classification of IS inflammatory phenotype in clinical practice.
最近的研究发现，诱导痰（IS）中的炎症细胞所决定的哮喘炎症表型存在变异性。本研究的目的是确定IS中炎症表型变异性的频率及影响因素。
回顾性观察研究，纳入61例哮喘患者，这些患者在5年期间至少接受了两次IS检测。根据其基线炎症表型进行分类，随后根据表型变异性（持续性嗜酸性粒细胞性、持续性非嗜酸性粒细胞性和间歇性嗜酸性粒细胞性）进行分组。收集所有病例的人口统计学、临床和功能数据以及可能影响IS变异性的因素。
61例患者中，31例（50.8%）的基线炎症表型发生了变化。其中，16例（51.6%）为嗜酸性粒细胞性，5例（16.1%）为中性粒细胞性，1例（3.2%）为混合性，9例（29.1%）为少粒细胞性。根据表型变异性，18例患者（29.5%）被分类为持续性嗜酸性粒细胞性，17例（27.9%）为非持续性嗜酸性粒细胞性，26例（42.6%）为间歇性嗜酸性粒细胞性。吸烟和近期哮喘加重与IS炎症表型变异性风险增加显著相关（OR分别为6.44；p = 0.013；95%CI = 1.49 - 27.80和OR为5.84；p = 0.022；95%CI = 1.29 - 26.37）。
一半的哮喘患者，主要是那些嗜酸性粒细胞表型的患者，其IS炎症表型会发生变化。这种变异性与吸烟和近期哮喘加重有关。数据表明这些因素在临床实践中可改变IS炎症表型的分类。
