Endotypes identified by cluster analysis in asthmatics and non-asthmatics and their clinical characteristics at follow-up: the case-control EGEA study
Background Identifying relevant asthma endotypes may be the first step towards improving asthma management. We aimed identifying respiratory endotypes in adults using a cluster analysis and to compare their clinical characteristics at follow-up.Methods The analysis was performed separately among cur...
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/7/1/e000632.full |
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| author | Isabelle Pin Jocelyne Just Rachel Nadif Valérie Siroux Mickael Febrissy Miora Valérie Andrianjafimasy Nicole Le Moual Frederic Gormand Régis Matran Orianne Dumas Mohamed Nadif |
| author_facet | Isabelle Pin Jocelyne Just Rachel Nadif Valérie Siroux Mickael Febrissy Miora Valérie Andrianjafimasy Nicole Le Moual Frederic Gormand Régis Matran Orianne Dumas Mohamed Nadif |
| author_sort | Isabelle Pin |
| collection | DOAJ |
| description | Background Identifying relevant asthma endotypes may be the first step towards improving asthma management. We aimed identifying respiratory endotypes in adults using a cluster analysis and to compare their clinical characteristics at follow-up.Methods The analysis was performed separately among current asthmatics (CA, n=402) and never asthmatics (NA, n=666) from the first follow-up of the French EGEA study (EGEA2). Cluster analysis jointly considered 4 demographic, 22 clinical/functional (respiratory symptoms, asthma treatments, lung function) and four blood biological (allergy-related, inflammation-related and oxidative stress-related biomarkers) characteristics at EGEA2. The clinical characteristics at follow-up (EGEA3) were compared according to the endotype identified at EGEA2.Results We identified five respiratory endotypes, three among CA and two among NA: CA1 (n=53) with active treated adult-onset asthma, poor lung function, chronic cough and phlegm and dyspnoea, high body mass index, and high blood neutrophil count and fluorescent oxidation products level; CA2 (n=219) with mild asthma and rhinitis; CA3 (n=130) with inactive/mild untreated allergic childhood-onset asthma, high frequency of current smokers and low frequency of attacks of breathlessness at rest, and high IgE level; NA1 (n=489) asymptomatic, and NA2 (n=177) with respiratory symptoms, high blood neutrophil and eosinophil counts. CA1 had poor asthma control and high leptin level, CA2 had hyper-responsiveness and high interleukin (IL)-1Ra, IL-5, IL-7, IL-8, IL-10, IL-13 and TNF-α levels, and NA2 had high leptin and C reactive protein levels. Ten years later, asthmatics in CA1 had worse clinical characteristics whereas those in CA3 had better respiratory outcomes than CA2; NA in NA2 had more respiratory symptoms and higher rate of incident asthma than those in NA1.Conclusion These results highlight the interest to jointly consider clinical and biological characteristics in cluster analyses to identify endotypes among adults with or without asthma. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2020-09-01 |
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| spelling | doaj-art-5ca91af166504d8f8a1691453eff37d12024-11-24T01:10:08ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392020-09-017110.1136/bmjresp-2020-000632Endotypes identified by cluster analysis in asthmatics and non-asthmatics and their clinical characteristics at follow-up: the case-control EGEA studyIsabelle Pin0Jocelyne Just1Rachel Nadif2Valérie Siroux3Mickael Febrissy4Miora Valérie Andrianjafimasy5Nicole Le Moual6Frederic Gormand7Régis Matran8Orianne Dumas9Mohamed Nadif10Department of Pediatrics, CHU de Grenoble Alpes, Grenoble, France5 Service d`Allergologie Pédiatrique, Hôpital d`Enfants Armand-Trousseau, Assistance Publique - Hopitaux de Paris, Paris, France1 Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d`Épidémiologie respiratoire intégrative, CESP, 94807, Villejuif, Île-de-France, France2 IAB, Team of Environmental Epidemiology Applied to Development and Respiratory Health, INSERM U1209, University of Grenoble-Alpes, CHU de Grenoble, Grenoble, FranceUniversité de Paris, LIPADE, Paris, FranceUniversité Paris-Saclay, UVSQ, Université Paris-Sud, Inserm, Équipe d`Épidémiologie Respiratoire Intégrative, CESP, 94807, Villejuif, FranceUniversité Paris-Saclay, Paris, FranceCHU de Lyon, Pneumology Department, Lyon, FranceUniversité de Lille Nord de France, Lille, France1 Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d`Épidémiologie respiratoire intégrative, CESP, Villejuif, FranceLIPADE, Université de Paris Descartes, Paris, FranceBackground Identifying relevant asthma endotypes may be the first step towards improving asthma management. We aimed identifying respiratory endotypes in adults using a cluster analysis and to compare their clinical characteristics at follow-up.Methods The analysis was performed separately among current asthmatics (CA, n=402) and never asthmatics (NA, n=666) from the first follow-up of the French EGEA study (EGEA2). Cluster analysis jointly considered 4 demographic, 22 clinical/functional (respiratory symptoms, asthma treatments, lung function) and four blood biological (allergy-related, inflammation-related and oxidative stress-related biomarkers) characteristics at EGEA2. The clinical characteristics at follow-up (EGEA3) were compared according to the endotype identified at EGEA2.Results We identified five respiratory endotypes, three among CA and two among NA: CA1 (n=53) with active treated adult-onset asthma, poor lung function, chronic cough and phlegm and dyspnoea, high body mass index, and high blood neutrophil count and fluorescent oxidation products level; CA2 (n=219) with mild asthma and rhinitis; CA3 (n=130) with inactive/mild untreated allergic childhood-onset asthma, high frequency of current smokers and low frequency of attacks of breathlessness at rest, and high IgE level; NA1 (n=489) asymptomatic, and NA2 (n=177) with respiratory symptoms, high blood neutrophil and eosinophil counts. CA1 had poor asthma control and high leptin level, CA2 had hyper-responsiveness and high interleukin (IL)-1Ra, IL-5, IL-7, IL-8, IL-10, IL-13 and TNF-α levels, and NA2 had high leptin and C reactive protein levels. Ten years later, asthmatics in CA1 had worse clinical characteristics whereas those in CA3 had better respiratory outcomes than CA2; NA in NA2 had more respiratory symptoms and higher rate of incident asthma than those in NA1.Conclusion These results highlight the interest to jointly consider clinical and biological characteristics in cluster analyses to identify endotypes among adults with or without asthma.https://bmjopenrespres.bmj.com/content/7/1/e000632.full |
| spellingShingle | Isabelle Pin Jocelyne Just Rachel Nadif Valérie Siroux Mickael Febrissy Miora Valérie Andrianjafimasy Nicole Le Moual Frederic Gormand Régis Matran Orianne Dumas Mohamed Nadif Endotypes identified by cluster analysis in asthmatics and non-asthmatics and their clinical characteristics at follow-up: the case-control EGEA study BMJ Open Respiratory Research |
| title | Endotypes identified by cluster analysis in asthmatics and non-asthmatics and their clinical characteristics at follow-up: the case-control EGEA study |
| title_full | Endotypes identified by cluster analysis in asthmatics and non-asthmatics and their clinical characteristics at follow-up: the case-control EGEA study |
| title_fullStr | Endotypes identified by cluster analysis in asthmatics and non-asthmatics and their clinical characteristics at follow-up: the case-control EGEA study |
| title_full_unstemmed | Endotypes identified by cluster analysis in asthmatics and non-asthmatics and their clinical characteristics at follow-up: the case-control EGEA study |
| title_short | Endotypes identified by cluster analysis in asthmatics and non-asthmatics and their clinical characteristics at follow-up: the case-control EGEA study |
| title_sort | endotypes identified by cluster analysis in asthmatics and non asthmatics and their clinical characteristics at follow up the case control egea study |
| url | https://bmjopenrespres.bmj.com/content/7/1/e000632.full |
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