普通人群中现患哮喘的特应性、嗜酸性粒细胞性和TH2高表达哮喘表型的重叠情况。

Overlap of atopic, eosinophilic, and TH2-high asthma phenotypes in a general population with current asthma.

作者信息

Tran Trung N, Zeiger Robert S, Peters Stephen P, Colice Gene, Newbold Paul, Goldman Mitchell, Chipps Bradley E

机构信息

Global Medicine Development, AstraZeneca, Gaithersburg, Maryland.

Kaiser Permanente Southern California, San Diego, California.

出版信息

Ann Allergy Asthma Immunol. 2016 Jan;116(1):37-42. doi: 10.1016/j.anai.2015.10.027.

DOI:10.1016/j.anai.2015.10.027

PMID:26707771

Abstract

BACKGROUND

Atopic, eosinophilic, and TH2-high asthma phenotypes may overlap, but the extent is unknown. Understanding the overlap across these phenotypes may be useful in guiding asthma patient care.

OBJECTIVE

To examine the frequency and overlap of atopic, eosinophilic, and TH2-high asthma phenotypes.

METHODS

We analyzed 2005 to 2006 data from the National Health and Nutrition Examination Survey. Patients with asthma were identified based on the participant self-report. Eosinophilic asthma was defined as a blood eosinophil cutoff point of ≥150, 300, or 400/μL. Atopic asthma was defined as having an allergen-specific IgE level of ≥0.35 IU/mL for any of the 9 perennial allergens tested. TH2-high asthma was defined as a total serum IgE of ≥100 IU/mL and a blood eosinophil count of ≥140/μL.

RESULTS

The study included 269 children and 310 adults. Depending on the eosinophil cutoff used, 31% to 78% of children and 21% to 69% of adults with asthma were classified as having eosinophilic asthma. In addition, 63% of children and 61% of adults were classified as having atopic disease and 48% of children and 37% of adults as having TH2-high asthma. At a higher eosinophil cutoff point, a greater proportion of eosinophilic asthma can be classified as atopic or TH2 high, but a lower proportion of atopic or TH2-high asthma can be classified as eosinophilic. Approximately 70% or more of children and adults with asthma were 1 of these 3 phenotypes.

CONCLUSION

A considerable overlap among eosinophilic, atopic, and TH2-high asthma phenotypes exists in a general asthma population.

摘要

背景

特应性、嗜酸性粒细胞性和TH2高表达哮喘表型可能存在重叠，但重叠程度尚不清楚。了解这些表型之间的重叠情况可能有助于指导哮喘患者的护理。

目的

研究特应性、嗜酸性粒细胞性和TH2高表达哮喘表型的频率及重叠情况。

方法

我们分析了2005年至2006年美国国家健康与营养检查调查的数据。根据参与者的自我报告确定哮喘患者。嗜酸性粒细胞性哮喘定义为血液嗜酸性粒细胞计数临界值≥150、300或400/μL。特应性哮喘定义为对于所检测的9种常年性变应原中的任何一种，变应原特异性IgE水平≥0.35 IU/mL。TH2高表达哮喘定义为总血清IgE≥100 IU/mL且血液嗜酸性粒细胞计数≥140/μL。

结果

该研究纳入了269名儿童和310名成人。根据所使用的嗜酸性粒细胞临界值，31%至78%的哮喘儿童和21%至69%的哮喘成人被归类为嗜酸性粒细胞性哮喘。此外，63%的儿童和61%的成人被归类为患有特应性疾病，48%的儿童和37%的成人被归类为患有TH2高表达哮喘。在较高的嗜酸性粒细胞临界值时，更大比例的嗜酸性粒细胞性哮喘可被归类为特应性或TH2高表达，但较低比例的特应性或TH2高表达哮喘可被归类为嗜酸性粒细胞性。大约70%或更多的哮喘儿童和成人属于这三种表型中的一种。